Faryal Hamed
May 2016
Halb, Kingdom of Saudi Arabia
Faryal Hamed, 41, walked along the sidewalk patterned with yellow and black borders. Her black garment danced with the soft wind behind her to reveal her tan heels. Faryal reached her hand out for Ameerah Hamed, 13, and dressed in her school uniform of a navy-blue top and plaid-grey skirt. Its logo read Deutsche Internationale Schule Halb.
Halb was a small city populated by short, glass-walled buildings accented with sand-colored walls. Dark green palm trees filled the spaces in between buildings and roads. The few roads that lead out of the city were met with flat lands and sand dunes in the far distance of their gaze.
Ameerah already had her mother's figure -- both slim with long, dark brown hair. Faryal put on her sunglasses in sight of the sun, as it baked the hot summer day to about 32 Celsius. Traffic was halted beside them for strolling pedestrians, as women in identical black garments pushed strollers across the city street. Surrounding road signs read in both English and Arabic.
Halb was a giant suburb. As they walked, Faryal thought about the thousands of lives living here, all so unique and different from one another. She came to realize that other people's lives, which seemed so normal, were far from it. Public streets were always uneventful, but private lifestyles here resulted in events that only occurred behind closed doors.
The day's second call to prayer sounded as they entered the market streets. Men in white garments carried boxes of oranges, citruses, and dates inside their shops. Faryal smelled the fresh bread, the baskets of jasmine tea leaves, the dried fruit. It smelled like her childhood. The smells longing for another smell. A nostalgic enchantment of brew and sand. There was no elixir quite like it.
Faryal passed by shop advertisements, some of women's fashion, which had the women's faces blurred. They exited the markets and joined a small crowd in the clearing surrounding their mosque.
The mosque ahead had a tall, slim tower with a circular balcony at the top. The two neared it as the muezzin's calls sounded through the site's speakers, "God is great. God is great."
Faryal and Ameerah joined the crowd gathering at the entrance, passing under the horseshoe arches, all removing their shoes and entering further inside.
*
Ameerah was by Faryal's side inside the women's prayer hall. Rows and rows of veiled women joined in closing their eyes and lifting their hands. Everyone was on their knees on ornate prayer rugs of various colors.
After prayers, the women and children all joined in the men's prayer hall. All the men were grouped in the front rows, as the others sat behind them. Faryal looked at towards her periphery as the Mutaween, the religious police, walked back and forth among those sitting.
Everyone was turned to the front of the hall, where the imam spoke through a microphone.
The imam stroked his long beard in contemplation, "Blessed be Allah, the best of the creators. And you will most certainly find them the greediest men for life, every one of them loves that he should be granted a life of a thousand years… And his being granted a long life will in no way remove him further off from punishment. And Allah sees what they do."
The imam returned to his stand, flipped along pages of the Holy Qu'ran and read from it, "Ash-Shu'ara, verse eighty-eight to eighty-nine says, 'The day when wealth and sons avail not any man. Save him who bringeth unto God a whole heart."
The prayer hall's chandelier shined in bright radiance from overhead. Looking up from above, its lights formed thin strings of rays which emanated from its brightest center. Bulbs spread around in circles and in layers deeper within these circles until they were bundled tight together in the chandelier's crater.
Marble, column arches surrounded the hall. And the walls were designed with arches and calligraphic artwork underneath them. Painted strokes of art and words and the meaning the art and words conveyed.
The imam continued, "Illnesses continue to sweep the country, and for those with loved ones, God shall grant you strong hearts in the times to come. Chapter ten, verse fifty-six, 'He gives life and causes death, and to Him you shall be brought back.' Because for those that find themselves in these troubled times, know, that God would not put a burden on a man's shoulders knowing he could not carry it."
The imam cleared his throat, "So be not in doubt of it, and follow me. This is a straight path. May this Ramadan be successful for all of us. May Allah accept all our prayers in this Ramadan. May all of us be blessed with love and the protection of Allah. May this Ramadan be a month of blessings, guidance, and forgiveness for all of us. Praise be to Allah."
*
Hamed Residence, Halb Oasis Village Compound
Faryal and Ameerah turned from the sidewalk and stopped by their home's surrounding walls. There was a black, metal, and automatic gate which led to the driveway. Beside it was a door-shaped gate of similar material. Faryal unlocked the door gate and began walking the steps towards their home.
The pathway to their door was natural stone, where each piece was unique in color, design, and shape. Individual and different from the rest, like cracked stone that rippled throughout its path. Their two-story home was a combination of the same natural stone pattern, along with tan walls accented with archways along the front porch.
Faryal unlocked the door as the two stepped onto light brown stone flooring, all the same color, and glossed in the interior lights. The air conditioning hymned to greet Faryal with a cold front. She sealed their comfort by shutting the door. A walnut sideboard beside them held a moving sand picture, in metal frame, where sky-blue sand infused with black sand to fall and collect in its lower layer among an azure blue backdrop – only to be flipped later and restart the entire process.
Their Filipino housekeeper, Andrew, walked out of the hallway holding onto his cleaning kit, "Afternoon,"
The two greeted him with a smile, "Hello."
"I just finished for today, I'll see you guys next week."
Faryal opened the door for him as they both nodded farewells. She turned to Ameerah, "Help me cook for the food drive, then your dad can take it to the mosque tonight so they can give it out."
"Okay."
The mosque would prepare for its first breaking fast tonight, and those without food security could come to the mosque for free meals. Muslims, individually and through their institutions, had a duty to fight hunger and poverty.
Walking towards the kitchen, Faryal passed by an artwork of the human heart, colored in salmon pink. Tree trunk veins grew out into thinner branches that spread across the heart. The organ's vessels were open like the end of straws, to only show the heart and the heart alone.
Faryal washed and began cutting vegetables in the kitchen styled with dark marble counters. Her headdress was rested around her shoulders to let her hair flow outward. Mainly black, he hair was a mix of brown and soft curls ending just above her shoulders.
***
King Faisal Medical Clinic
Faryal walked the hallways of the King Faisal Medical Centre's outpatient clinic. It was a small building right beside the hospital that shared its design. She had on a maroon blouse and her white lab coat. Pens in her pocket, ID badge clipped, and pager attached on her. Faryal passed by the front of the elevators, where the reception wall displayed the hospital logo and name in soft blue LED lighting. Faryal entered an exam room, surrounded by dark cherry wood walls.
Her next patient was 70-year-old Soha Sabet, who sat on the exam bed, with her white hair peeking through her veil. Soha greeted her, "Salam, doctor."
"Salam."
Faryal turned to see a woman in scrubs offer her hand, "Hello, I'm Soha's caregiver."
They shook, "Perfect, hello. It's great that you brought her here today."
Faryal sanitized her hands and opened her patient folder, "How are you feeling?"
She sighed with a slump and a frown, "Not good. Last year I came here with a lot of pain, I didn't have any energy… and…" She shut her eyes and reopened them, "My joints were swelling. I could barely tend my garden. They took blood and said I had arthritis --"
Faryal had flipped through her past exam and clarified, "Rheumatoid arthritis, correct?"
"Yes. They gave me all kinds of meds. And I was feeling fine after a while, but then this morning my hips were hurting. And the pain was worse this time, I tell you."
Faryal frowned, "Aw, I'm really sorry to hear that… I see… You were also tested for MERS and… Acute pancreatitis?"
That was odd. She was tested for 2 different diseases and the doctor ended up with arthritis? And…
Faryal brought the folder closer to make sure she was reading it right. Even after the tests came back negative, it was followed up with additional disease-related services for MERS and the acute pancreatitis. What?
The kind lady flapped her hand, "They did all kinds of tests. Fancy word this, fancy word that. You can't keep track... Did feel better to know all these people were doing so much work to make sure they do the right treatment"
Faryal nodded, "… Of course."
"But… I tested negative right?"
"Oh, yes. You did, it's just I don't know why they would test that at all… Did you have trouble breathing? Coughing? Shivering of any kind?"
"No, nothing like that."
"And what about a loose stool? Pain in the middle of your stomach?"
"No, gosh, that sounds worse."
Faryal closed her file, "Well, I'll start off with an x-ray," Which is what the past doctor should have done, "And make sure if you really have arthritis or not."
Soha nodded, "Okay, thank you."
Faryal smiled, "Of course."
She was not sure what Soha had, but it sure was not arthritis.
***
The next day, Soha's tests had arrived for Faryal. She sat in one of the clinic's break rooms and read the results. Fibromyalgia. Faryal took the next hour to contact Mrs. Sabet and relay the results, then they went on to coordinate her treatment. The woman had gone a year misdiagnosed, provided odd tests, and the wrong treatment.
Faryal checked her watch as its gold band danced along her wrist. Noon. Lunch break. Faryal was making her way to the clinic reception area. An unsettling idea kept gnawing at her since yesterday. Just how many unnecessary procedures were being done in the clinic? Perhaps it was just that doctor. Faryal had to make sure.
There was a collection of folders on the nurses' counter of patients that had just been seen. They were waiting to be digitized before being filed. Faryal approached one of her friends, Nameera, who was known for her animal-printed scrubs. Today her scrubs had horses.
"Horsies!"
Nameera smiled and looked up from behind the counter, "It's been a big hit today."
"You know I rode equestrian when I was in college?"
Nameera's jaw dropped with a gasp.
Faryal continued, "My favorite, she was an Arabian horse," she gazed away, "her skin was like coffee brown. They're excellent endurance horses -- but she was so sensitive. But very beautiful."
"That sounds so amazing. In Beirut? You were born there, right?"
Faryal nodded but then her gaze and smile slowly faded.
She put a hand on the stack of folders, "Any chance you could let me take a look at these?"
"… Okay… But if anyone needs one of them, I'll have to say you have it."
"Thanks, Nameera."
Faryal brought the stack of folders back into her office. She lowered it to the dark brown carpeting and sat crisscross beside them. Faryal took the first folder off the stack and opened it. She looked at their summaries for today's visit, the tests/treatments done, and the conclusions the doctors made. Faryal needed to make sure the means correlated with both the symptoms claimed by the patient and the doctor's diagnoses.
She closed the folder of the first file and moved on to the next. Her eyes scanned left to right, moved down, left to right again. Flipped over the page and scanned it over in the same pattern. One by one, the folders of the stack decreased from the initial pile and collected on the finished pile.
When Faryal finished, she stood up and slowly paced in the small space in front of her desk. Faryal had her hands on her hips and was making sense of everything she had seen. 4 patients today tested for MERS, Middle Eastern Respiratory Syndrome, which has been growing in the country. These 4 patients came in with different symptoms from one another -- and different symptoms from those seen in MERS. And they were each seen by 4 different doctors -- one of which included Mrs. Sabet's last physician… Now, the doctors must have figured they could get away with testing and charging for MERS-related services because of the public's current fear from it. Patients must have thought, 'Why not make sure I don't have it'? Except that if they did not show symptoms, these services were unnecessary. And they were paying for it. And the doctors were making money off it.
Doctors get paid for doing more, not less. Patients like Mrs. Sabet may feel grateful for extra tests because it shows the doctor is 'being thorough' -- but it only diverts from services that dig at the true cause of their symptoms.
4 clinic doctors were ordering pointless services just today. Is pointless medical care really that widespread? And apart from MERS, what other services were patients being exploited for?
Faryal quickly picked up the stack and jogged out of her office and down the hallway. She made it to the nurses' counter and returned the stack of folders. Faryal checked her watch, 13:05.
Nameera stood up and held out a patient folder to Faryal, "Did you have a good lunch? She's waiting in exam room one."
*
Faryal clocked out at 18:02. She rushed towards the nurses' counter and asked Nameera, "Can you help me navigate the nurses' system?"
Faryal pulled up a chair and the two huddled around Nameera's computer.
"What are you looking for?"
"I just want to do a crude check. Would I be able to see visit summaries?"
"Sure, but you would have to see them individually. We only ever compile them into broad data when we provide yearly summaries to insurance companies. How far back do you want to look through?"
"The past year."
Nameera whistled, "I'll keep my computer logged in, but Rafa's in the lot waiting for me."
Faryal smiled, "Thanks for this. Good night."
Nameera stood with her jacket over her arm, "Good night, Faryal. See you tomorrow -- and good luck."
Faryal combed through visit summaries. Basically, digital files of the patient folders but a year's full of them. There were multiple computers with the nurses' system along the reception counter. The nurses that clocked in took the seats of their own stations, getting up, grabbing folders, attending to the next patient.
Doctors, nurses, patients, and families moved by and around the counter. Movements, sounds, yells, whispers -- all faded into ambient noise in the back of Faryal's mind. Their motions blurred in the corners of her eyes. Strobes of back-and-forth movement. Faryal's eyes never left the screen. Clicking. Typing. Her index finger snapped periodically along the mouse as her right hand joined her left in dancing against the keyboard. They danced in the motion of a piano tune playing jazz. Jumbled but fast. The mouse clicks were drum beats. Clicking. Typing. Her eyes scoured the screen, next file, next file, next file.
"Faryal."
Her eyes broke from the screen and she saw Naseem looking over the counter, "I thought you took an Uber home, I've been calling you."
Faryal instinctively patted her lab coat pocket, "I left it at my office."
She looked at her watch as her husband concurred, "It's twenty-one hundred."
*
Faryal sat in the passenger seat of their Range Rover as Naseem drove in light traffic. The street lights dazzled through her window as she stared blankly. The roads, pedestrians, shops, homes, and buildings passed by without eye movement.
Dozens of patients had come in to the clinic during the past year with various conditions. Hernias, fatty lumps, thyroid symptoms. They had all been given high-cost tests of no correlation to their symptoms and the doctor's conclusions. They made no sense in being done in the first place. Those with thyroid symptoms underwent neck biopsies and ultrasounds. Standard. But then all were sent for MRIs by different doctors in different months. An MRI does not detect for thyroid diseases as well as biopsies and ultrasounds. So why do them?
Because they are expensive.
Dozens of patients had received drugs that were not helping them, scans and tests that only cost more money. Some even causing harm. And certain doctors were recommending surgeries that Faryal would have never advised. And these patients went under anesthesia and went under the knife for them. Insurance is billed for every procedure, every drug, every consultation. And the hospitals rake them in.
Naseem stopped at a light as Faryal watched a family gather by the entrance of a shop corner. The lights inside were flickering. A little boy and girl were carrying boxes of chips into the store as a veiled woman swept the dirty, tiled floor behind them.
Faryal remembered The Hippocratic Oath, 'I will apply, for the benefit of the sick, all measures that are required, avoiding those twin traps of overtreatment and therapeutic nihilism.'
These were one of the rules doctors were bound to. What was the point of having rules if people that broke them were not punished?
***
Faryal sat in her clinic office the next day. Color-coded folders and stacks of papers lined across her cherry wood, executive desk. These were the folders of all the patients that had been mistreated. The hospital had profited off patients in need of their best possible care at reasonable costs. Only, she could not take their personal medical records to an attorney without their consent. Faryal sat with her back along the black, leather chair. Elbows on the armrests, and hands together in contemplation.
She just only needed to nudge them, or at least most of them, towards a similar law firm. She began searching online for malpractice attorneys. Faryal came across the infamous German attorney – Arielle Grossman. Her firm was under the hospital's malpractice insurance, and she was among the best in the city at this. Grossman's latest case certainly tore the heart of the victim family. The only other person as high-powered, but who surely antagonized the hospital board, was Abdul Aden.
Faryal leaned over in her black, leather chair and picked up her phone.
*
Faryal put down her phone. She had just finished speaking with Mr. Aden, and he would prepare a medical malpractice litigation on behalf of the affected patients or surviving family members – a few of which had passed away over the past year.
She picked her phone up again and dialed off the patient folder open in front of her. It was ringing.
"Salam, Mister Mohammed Javid?"
The voice on the other end replied, "Salam, this is Mohammed."
"My name is Doctor Faryal Hamed from King Faisal Medical's outpatient clinic. Last month, you were seen because you had an allergic reaction, is that right?"
"Yes, that's right."
"A number of tests had been done during your visit, some of which, I believe did not warrant them in the first place. And I believe you, among dozens of other patients, to be the victim of profit-maximizing by the hospital."
"And you're calling from them same hospital?"
The two chuckled, "Yes, but this isn't an official call. My ultimate goal here is policy change within the hospital, but as long as they keep profiting, the board will never do so. And a lawsuit that is publicized and which forces them to pay out will force this change. There is a medical malpractice attorney preparing a class-action suit against the hospital, so let me give you his information."
Faryal gave him Mr. Aden's information as they thanked each other and bid farewells. Faryal put down her phone, picked up her pen, and crossed off his number listed on a sticky note. There were 4 patient names and their phone numbers on each sticky note, and 5 separate sticky notes on her desk.
Faryal put down her pen, picked up her phone, and started dialing again.
***
Arabian Nights Restaurant, Riyadh
Faryal and Naseem stepped off the street and onto the sidewalk, walking side-by-side. Faryal's black heels clicked on the herringbone-patterned brick path. Her tan pink dress danced with her figure as she was striding with eye-catching form. And Naseem was dressed in a black and white suit and tie; with a hand along her back. A heavy traffic of cars was stopped behind them in the downtown street.
Large and grand marble columns surrounded the restaurant's dining floor. Its high ceiling held a wide chandelier of glimmering white arms that sprawled outward. Stalagmite prisms of light-catching reflection in every direction above. Marble floors. The restaurant was furnished with dark brown wood tables and black leather seats.
Walls separated the men's half of the dining area from the women's half. Faryal kissed and hugged her friends, then sat down to join them. The table included Amalia and Nameera.
Their large table was filled with purses, phones, and crystal-clear glasses of water. The women had their headdresses down around their shoulders. Faryal's friends were dressed in fashionable abayas, ornate jeweled and hand embellished; gold bracelets along their wrists and designer watches.
A waitress walked to their table, "Your male server will be coming shortly with your meals."
The women around the table began wrapping around their headscarves.
Nameera spoke, "Which reminds me. I was talking to one of the new nurses at the clinic, an American, and she goes --" her voice slowed to mimic the accent, "So, like, about your headdresses… Don't you, like, feel oppressed?"
The women's heads turned as Nameera continued, "Like I feel sorry that you have to wear these. Especially in all this heat. It's barbaric."
Amalia asked, "What did you tell her?"
"I told her 'I'm not sorry. I'm proud."
Faryal added, "For her, it's just difficult to understand why a foreign religion and tradition are the way they are. As if we are aliens to them. But we're not so different – take France for example. They ban the burka, but look up a picture of a Catholic nun. They are veiled. Why? Because they are being modest in the presence of God."
Amalia nodded, "Even in the Bible, they have verses that refer to literal veils which should cover a woman's long hair for modesty."
Sara was one of the doctors at their table who worked in the ER. She added, "For me, I think, it helps remind me of who I need to be. You know? Like what my values are. It is this reminder that… I do not live for just myself. You live for God, and his will, and he has laid out this purpose for me as a doctor to help people." Sara brought her hands in front of her chest, "And so, I am honoring his power in my life."
The male server had pushed a metal tray by their table and brought everyone their meals.
The women began eating and continued to listen as another doctor, Nancy from cardiology, cleared her throat and added, "You guys know that I was in medical school in New York when nine-eleven happened. And it was just endless, classmates grabbed my hijab, professors told me I shouldn't come to class 'out of respect'. And, like, I was just as torn up as everyone was when it happened. There isn't a single collective Muslim society, as if we are a hivemind, and we agree on every view one of us brings up. Even among Islam, we have different sects, and different views. I got tired trying to explain to everyone I would come across, 'We aren't all alike."
Amalia finished chewing and asked, "Did it make you stop wearing it in public?"
"I'll admit I did, for a while. And then I realized that, you know, God is bigger than this. I may be out in public, eating, going to school, and people will feel uncomfortable… But it's only for that moment for them. My ancestors wore it, it's part of my culture, am I… Going to adopt someone else's and forget who I am? I realized that I wear it for me and that the rest of my life is much bigger than everyone else's brief, uncomfortable moment."
Sara spoke, "And last thing, your beauty isn't for the world's attention, but for your significant other. The one who can truly appreciate it. Because our beauty isn't the only thing that defines us, right?"
The waitress placed an espresso in front of Amalia, she leaned by Faryal's shoulder, "Retarted heart."
Faryal turned to see milk atop the espresso shaped a deformed heart, as thin tan-brown branches from the espresso mimicked its veins.
Sara reached her arm out to get everyone's attention, "Okay, all this talk made me remember a good one," she expressed her hands as she joked, "So he comes up to me and says, 'Hey, baby. Are you Muslim? Because you blow me away!"
The women could not help but laugh. Some of the women had their heads down at their phones as they did. Surrounding chatter sounded around them as the women continued to talk and laugh.
Faryal was continuing the conversation, "Ameerah told us she wants to be just like Naseem," she looked around the table, "she wants to be a heart surgeon."
Among the doctors especially, the women had blank responses.
Nancy broke the silence, "Oh… You guys probably won't agree with us –"
Sara added, "—But, take our word for it, love. You don't want your daughter to even think about becoming a doctor –"
Nancy joked, "—Or worse, a nurse."
Amalia and Nameera mocked at the two doctors from across the table. Faryal looked back at her food as her smile disappeared.
Sara justified herself, "It's just… It's little praise when you do it right. A lot of blame when you don't."
*
Hamed Residence, Halb Oasis Village Compound
Naseem and Faryal held hands in the car after passing the compound's security gate. Her husband stopped the Range Rover in their driveway and put it in park. The two got out and walked over to the lifting trunk, revealing a collection of shopping bags. Soft orange exterior lights shined on the large, dark green plants that stood by both sides of their archway entrance – leading to their double entry front doors.
The two entered to put down the designer store bags as Naseem shut the door behind them. Faryal put down her purse and Naseem put down the keys on the walnut sideboard. A modern, yet timeless, furniture of engineered wood veneer. Naseem brushed his hands along the dress which tightly hugged Faryal's waist, she began swaying her hips side to side. He kissed her neck. She closed her eyes.
Naseem walked and began playing Getz/Gilberto on the lone stereo in the spacious living room. He reached out his hand and Faryal held on as the two slowly danced. The serene vocals of Astrud Gilberto smoothed into the bossa nova groove of Getz' saxophone, and then was interrupted by piano keys. It was push and pull between the different rhythms and melodies.
The two stopped to look at each other. They smiled. Faryal watched him walk away into the kitchen, her smile faded with a sigh and sat down on one of their seats. Faryal hung her head back.
Naseem loosened the tie around his neck and opened the top buttons, exposing his chest. Naseem was in the kitchen, half his body cut off by the counter, he opened a top cupboard and took out a small, glass Canadian maple syrup bottle. Only, it did not have syrup. Her husband took out a glass and poured himself rum from the bottle.
It was haram. It was illegal. Faryal knew. But Naseem had a hard job. Cutting people open for a living was not for everyone. And for those that could stomach it, it is never easy. With an elbow on her chair's arm, Faryal looked back on when they first married. A wedding in Byblos under the moonlight, just before they flew away to begin their residencies. Which consisted of sending out 92 applications and attending 41 interviews. Both of their jobs had not been easy.
***
Faryal and Ameerah were in their front yard where wood sectioned off a rectangular piece in the sunlight.
The two were on their knees in the grass, wearing yard gloves, as Faryal pointed, "Your garden row should run north and south so that it takes full advantage of the sun. But these tomatoes need vigilant care because their susceptible to pests.
Last week, the mother and daughter dug into the soil a foot deep and mixed in aged compost. Now, Faryal showed Ameerah how to place tomato stakes in the soil along with their initial tomato plants.
"This keeps the roots from damaging later on."
After 13.8 billion years of the universe's existence, here this soil was created, planted, and watered. And it only needed a little more time to grow. This was how everything worked. This plant took billions of years to exist, and would only live a year so – a blink in the universe's timeline – that everything came together perfectly for this one plant. It was beautiful. The briefest blink makes all the waiting in the universe worth it. And we often live for the briefest moments. The moments that make all the waiting worth it.
Faryal continued to show Ameerah how to water, care for her plant, and keep it in the sunlight. The two smiled when they finished, and now all they had to do was wait.
"Come on, I want to teach you something else, too."
The two went back inside where Faryal brought a CPR dummy from the hospital and had it laid out in the living room space.
"You never know when someone around you needs your help. And sometimes, you could be their only hope of saving their life."
Faryal put down two pillows by the dummy's left side. They knelt down and stood over its chest.
Faryal continued, "If someone has collapsed, call for their attention. If they're not responding, call nine-one-one, explain what happened, put them on speaker, and they will ask you to do CPR. So, lean over first and check for breathing."
Ameerah leaned over and put an ear beside the dummy's mouth, Faryal straightened Ameerah's back and placed her hands over the center of the dummy's chest.
Faryal directed, "Push hard and fast. You have to really mean it. If you're not hurting them, you're not saving their life. I've performed CPR dozens of times, and I've broken or even dislocated ribs. And count aloud so the emergency responder can keep track with you."
On her own, Ameerah pushed down her hands twice per second, like a heartbeat, counting out, "One-two! One-two! One-two!"
***
King Faisal Medical Clinic
Faryal had just finished examining a patient. She clicked her pen and wrote on the patient's file – and lost her breath.
Faryal put a hand on the dark marble counter and bent slightly over. Her stethoscope and open, white lab coat dangled below her. It had been a terrible morning for her that began with aches in her arms. She reached across the counter for tissues and dabbed it along her watery eyes.
She breathed deep slowly and her chest felt strained. Faryal reached around her neck and put on her stethoscope – pressing the drum to her left breast, along her pulmonary valve, and listened. A faint murmur. She took a seat, straightened her back, and reached around to press the drum along her lower left lung. With every breath, there was a faint wheezing.
Her heart sank. No… Shit…
Faryal reached into her coat pocket, took out her phone, and called Naseem. The corner of her lip stretched as she spoke with worried eyes, "Nas?" Her heart began racing and she struggled to keep her breath, "… I need you…"
*
Faryal sat in the bed of the exam room. Her torso was naked and Naseem was listening along her back with his stethoscope.
She asked, "Do you think it's asthma?"
Naseem turned his ear, "You still having trouble breathing at night?"
Faryal nodded, "That's why it's more comfortable for me to sit up now when I sleep."
Naseem put the drum to her heart, and she hold on.
"… An arrhythmia… That wasn't there last time…"
Her heart dropped. He probably sensed that as well.
"Is it… Is it what I'm afraid it is?"
"I'll have to go get Nancy to do a formal examination, and we'll get an EKG over --"
Naseem was about to walk away when Faryal held onto his hands over her heart, her head dropped, and Naseem shook their hands, "Hey, everything's going to be okay. Okay?"
His smile helped to bring out her own. But only for a moment. At this point, it was official despite her husband wanting to triple-check. Naseem was never wrong.
*
Naseem had returned with Nancy, and after half an hour of testing, all three doctors were looking over Faryal's EKG results.
Nancy explained, "So a normal heart's ejection fraction is fifty to seventy-five percent. Yours is just at that heart failure limit of forty… But it's likely going to keep declining, so will your ability to be active."
Nancy and Naseem watched her reaction, the news had stolen the breath out of her. But… I feel fine. I really don't feel that awful.
Faryal was in disbelief, "A forty-one-year-old, physically active woman can have congestive heart failure?"
The two nodded as Nancy continued, "Unfortunately we've seen patients have CHF with little or even no symptoms. I diagnosed a woman as young as thirty-two years old once."
Faryal had always preached it to her own patients. Good genes and good exercise can give you a long life. But fate can cut all that in an instant.
Faryal asked, "What do you think is the cause?"
"I would say familial dilated cardiomyopathy."
Naseem added, "Your father had his heart condition."
Nancy nodded, "So that's likely genetic. We'll have to watch out for vomiting in the coming weeks, I'll start you with some medication and see how you do, love."
Ugh! We're basically letting my current heart work until it can't anymore.
Nancy asked, "I know you said you quit smoking but have you been smoking recently?"
Faryal gave a slight shrug, "A few cigarettes here and there."
"Okay, well goes without saying, stop immediately. I know you might want one right now – I know I do, I am so sorry, love. God will watch over you, do not lose trust in him."
Her friend rubbed her shoulder and Faryal held on.
"And have you been smoking –" Nancy mimicked smoking weed.
"Also, when I've been stressed."
"I'd recommend stopping that as well, love, although it can help with the coming nausea and vomiting – I'd say it's strain on the heart and lungs has more costs than benefits in your case. As you know, doctors make the worst patients… For now, you still do not have to be admitted."
Faryal nodded understandingly. But then her head dropped. As if she suddenly lost control of her life. Nancy and Naseem's diagnoses of CHFs had similar paths. They wouldn't respond well to medical therapy. It was a rough, long road. And they had maybe three, four years until their hearts failed them… Is this it for me? Is this how I die?
Faryal let out a sob, she leaned down to bury her tearful eyes in her hands. She felt Naseem and Nancy's hands on her.
Naseem spoke, "Hey, hey. Look at me."
Faryal sniffed and brought up her head, she wiped her arm along her nose. Her eyes met with her husband's.
"Do I look worried?"
The two had their heads close together, his reassuring smile and gleaming eyes were in contrast to her own expression. Faryal shook her head.
"No, because I know we can deal with this. Especially now that we know… You trust me, right?"
Faryal nodded with pouted lips.
He brushed his wife's hair behind her ear and his warm fingertips glazed her cold cheeks, "We're going to beat this. You and I. Whatever it takes."
Faryal's eyes drifted as she felt more tears rush in. Her lips stretched towards her cheeks, "… And Ameerah?"
Naseem touched her chin to direct her eyes back at him, "Hey, hey—"
"I don't want to leave her, Nas…"
"That's not going to happen. This is what we're going to do, we're going to start with getting you on a donor list. Okay? Perhaps three…" he looked to Nancy, "Six months? We'll find you a donor and everything will be okay."
The two kept their heads close and Faryal returned her eyes to him. The two nodded.
Naseem straightened his back, "I'll start speaking with the transplant coordinator, I should take her file, who's on right now? Haibaa?"
Nancy handed him Faryal's file, "Yes – no, actually today is Thursday, Omar is the present coordinator."
Naseem left the exam room and left the two women alone. Faryal wiped her eyes with her fingertips. She got off the exam bed, put on her lab coat, and wrapped her stethoscope around her neck.
Nancy asked, "Love, what are you doing?"
Faryal rushed towards the door and made sure her phone and pager were on her, "I have to get back to work. There are patients waiting for me."
"Faryal –"
And she shut the exam room door behind her.