Visiting Surgeon in the Middle East: Part 12

Wissam’s brother picked us up at the airport and they quickly dropped me off at my hotel as I think Wissam was anxious to see his mother. The hotel was a trendy American chain that was in a bustling downtown area. The first thing that struck me after my time in Saudi Arabia and Kuwait was the bar. I checked in, dropped my things in my room, and decided to have a nightcap to celebrate my safe exit from the Arabian Peninsula at this precarious time. I sampled a local Northern Lebanese white table wine. Despite my low expectations (and, perhaps, Californian affectations) I was blown away by the complex flavors. This was not a response to being in wine-free countries as this experience was replicated over the next few days. The Lebanese can make wine!

The next morning Wissam picked me up, and we stopped by their corporate office in Beirut to get the rest of his team. From my hotel in downtown near the Mediterranean, we headed east past the infamous Green Line, a flashpoint and heavily contested area dividing the Muslim and Christian sections of Beirut. Though life on the street seemed to be going on just like in any other big city, I could not help but notice the occasional pockmarked building and soldiers around armored personnel carriers on every corner. Interestingly, however, the soldiers were always outside of their vehicles chatting with folks on the street. If they were not worried, I wouldn’t be either.

Visiting Surgeon in the Middle East: Part 11

I had the afternoon to myself. Rather than sleeping, I decided to wander around Kuwait City and check it out. The beachfront along the Persian Gulf was gorgeous. I had expected it to be full of freighters and tankers, but none were in sight. Rather, there were mostly jet skis catching air and doing tricks over their wakes in the Gulf. Am I really right next to Iran? The city is bustling, with any empty space the host of a large, multimillion-dollar construction project. I explored the area and found a lovely park along the water. I followed it and was accompanied by every facet of Kuwaiti society, rich and poor, native and immigrant. No matter where people come from, a beautiful coast will always serve as enticement to get people outside.

We then went to the airport en route to Beirut. Our flight was uneventful, except the time the pilot asked the passengers to put on their seatbelts as we were going over “unstable air.” I looked at the GPS and saw we just entered Iraqi airspace. I am still not sure if the pilot meant that as a matter of fact or a political joke.

We landed at Rafiq Hariri International airport. I was first struck by the beauty of it being right on the Mediterranean, but was later entranced at the incredible efficiency of that airport. At Raleigh-Durham, I expect to wait at least 20 minutes for my bag. In Beirut, Lebanon my bag beat me to the luggage carousel. My only quick stop was at customs, where a young woman in a Lebanese military uniform spent a long, uneasy 5 minutes (felt a lot longer) pouring over every page of my passport. No one else on my flight from Kuwait City got that treatment and, frankly, I was feeling a little discriminated against. Is this because Lebanese people have such a hard time getting visas to the US? I asked Wissam, a Lebanese citizen, and was told she was making sure I did not have an Israeli stamp in my passport. If one was found, he told me, I would be refused access into Lebanon. Though this same restriction is on the books in most Arab countries, it is most strictly enforced in Lebanon I was told. An American with an Israeli stamp landing in Riyadh or Kuwait would likely be harassed and “interrogated,” but it is only in Lebanon that one would be unequivocally denied access.

Visiting Surgeon in the Middle East: Part 10

We took a cab and went through new high-rise after high-rise to our hotel. Hungry, we stopped by the Lebanese restaurant at the hotel where they were showing a Madrid vs. Barcelona soccer match projected onto the side of the building. We ate delicious Lebanese cuisine that Wissam said rivaled his mother’s and watched the match. We smoke shisha (tobacco in a water pipe) and enjoyed the evening. A good match, and, oh, what great food. The hummus was crisp and lemony. The meats were lean. Oh, so good.

The next morning we woke early and went to the outskirts of Kuwait City to operate with some Kuwaiti surgeons. Surgery is such a small world that the Kuwaiti surgeons and I immediately bonded over a mutual friend who, though Kuwaiti, trained in California and Texas and now practices in Minnesota. Our world is a small one. We, together, completed a fairly complicated case with little drama. The OR’s were clean, large and filled will folks who were obviously very well trained. They challenged me on why I did certain things and how I could do it better. I liked this dialogue. I liked the fact that they did not just accept what I was doing but wanted to know why. These guys, I told myself, were going to be great surgeons.

We finished our case early and decided to go to lunch. I was taken to a restaurant on the Persian Gulf known for their fish. The local reps, all Egyptian pharmacists, joined us. This was the only conversation I had on this trip that was political and, wow, was it informative. As an American, I think we tend to get a perspective that may not be representative of Arabs. We had a long, frank discussion over phenomenal seafood, fragrant shisha, and a desire to understand one another. It was quite an education…. And meal. The Persian Gulf glistened, and I reveled in the luxury of having frank discussions with people of different perspective who could teach me their perspectives.

Visiting Surgeon in the Middle East: Part 9

We checked in, got our seat assignments, and uneventfully went through customs and security. Still insecure about current events, I kept a careful watch over each person and made sure that, even with my back to the terminal, I could watch everyone via a reflection in the large windows over the tarmac. I was not going to be a headline in tomorrow’s Al Jazeera.

Despite my consternation, our shopping in the terminal and boarding on the plane to Kuwait City was uneventful. The flight was pleasant, as they served my new favorite coffee with cardamom.

Kuwait, used to having Americans, has a fairly easy visa process for us in the airport. To pay the 3 dinar fee for the visa, I had to go to an ATM since they didn’t accept credit. At the ATM, I asked for 100 dinars, never thinking that our American Greenback was less valuable than the Kuwaiti currency. I gave the money to Wissam to pay for the visa, wondering why he asked me why I got so much cash for our short stay. I figured the value would be like $30, not the $350 that the bank charged me. How could the dollar be that meaningless against the Kuwaiti currency? Wissam, showing a tremendous amount of restraint despite his ignorant new friend, never said a thing, though I know he caught on to my mistake.

Visiting Surgeon in the Middle East: Part 8

We checked in, got our seat assignments, and uneventfully went through customs and security. Still insecure about current events, I kept a careful watch over each person and made sure that, even with my back to the terminal, I could watch everyone via a reflection in the large windows over the tarmac. I was not going to be a headline in tomorrow’s Al Jazeera.

Despite my consternation, our shopping in the terminal and boarding on the plane to Kuwait City was uneventful. The flight was pleasant, as they served my new favorite coffee with cardamom.

Kuwait, used to having Americans, has a fairly easy visa process for us in the airport. To pay the 3 dinar fee for the visa, I had to go to an ATM since they didn’t accept credit. At the ATM, I asked for 100 dinars, never thinking that our American Greenback was less valuable than the Kuwaiti currency. I gave the money to Wissam to pay for the visa, wondering why he asked me why I got so much cash for our short stay. I figured the value would be like $30, not the $350 that the bank charged me. How could the dollar be that meaningless against the Kuwaiti currency? Wissam, showing a tremendous amount of restraint despite his ignorant new friend, never said a thing, though I know he caught on to my mistake.

Visiting Surgeon in the Middle East: Part 7

Our patient continued to do well and, with my pride barely in tact, I left the hospital. With several hours until my flight to Kuwait, my local host, another Palestinian pharmacist, took me on a drive around Riyadh to see the sights. Architecturally, Riyadh has many world-class building. The only problem is that one can rarely see them due to the orange dust from the desert that continually shrouds the city. As a westerner, I saw many familiar chain restaurants and stores. But there was nobody in them…or anywhere. The streets are deserted. Sporadically, one might see a man walking on the street to a store, but you’d never see a woman. Never. I wondered where all the women were hiding.

We stopped in the corporate office to pick Wissam up before he and I were to go to the airport and onto Kuwait. The office was in a nondescript building in central Riyadh near several restaurants and clothing stores. Upon exiting the elevator, we encountered several men, none Saudi, smoking cigarettes in the corridor. They were very friendly and we exchanged pleasantries. I don’t think they were used to seeing Americans there, as their protracted gazes, though friendly, betrayed their confusion in seeing a Westerner at their work place. They all invited me in and were anxious to tell me about what corporate division they worked for.

On the way to the airport, we stopped and got a coffee. Strong and aromatic…delicious.

Visiting Surgeon in the Middle East: Part 6

We were to do a laparoscopic low anterior resection for an older man with colorectal cancer. The OR was large, but sparse. There were no booms descending from the ceiling like OR’s in the US. A single tower of German laparoscopic equipment greeted me like an old friend from high school. This was not the operating room that I expected from a country where most of my dollars were going. Driving around Saudi Arabia, one is struck by the size and opulence of the shopping malls. This was not on par with those malls.

Despite the shortcomings of the facilities, the technical skills of the surgeons and staff more than made up for it. I operated with a female surgeon who was very gifted. Together, we excised a very difficult, large cancer with little blood loss and a lot of fun. It WAS fun. Technically, we had synergy and, as surgeons, that is very hard to come by. After making short work of a tough tumor, we went back to the Chief’s office where the familiar sign was hanging. I went in anyway without knocking. Everyone was in their familiar places. A traditional Saudi lunch was ordered.

This consisted of grilled, lean chicken and rice served in the center of the table. Each person uses his hands to roll the rice into a ball and eat the chicken. Though I like to think of myself as manually deft, I felt uncoordinated as my rice fell apart before getting to my mouth and my chicken fell to the floor. My colleagues smiled graciously, but I felt they were wondering how I could operate on people yet drop my rice all over the floor. Actually, I was thinking the same thing.