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Commentary

Karkabi, Khaled MD, MMH

doi: 10.1097/01.ACM.0000414723.36250.f0
Medicine and the Arts
Free

Dr. Karkabi is chair, Department of Family Medicine, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; e-mail: khaledka@clalit.org.il.

Nawal El-Saadawi is an Egyptian physician and psychiatrist. She gained international recognition thanks to her efforts in advancing women’s rights in Islamic society, including a firm stand against female genital mutilation. One of the many books she wrote, Memoirs of a Woman Doctor, was published in 1960, five years after she graduated as a medical doctor from Cairo University. Although this story was written from a first-person perspective, El-Saadawi declared that it is not autobiographical. Yet, many parts of the story reflect her real life.

Memoirs of a Woman Doctor is the story of an ambitious, courageous, and nonconformist Egyptian female doctor. Being raised in a patriarchal culture, she endures oppression against women from the earliest stages of her life. She is not entitled to enjoy her childhood as male children are; instead, she must share domestic work with her mother, behave herself, and learn to be an obedient and supportive future wife. As a girl, she is not supposed to study, work, or have personal ambitions. Society, family, relatives, and friends not only discourage her from realizing her dreams but also insist that she exhibit “proper conduct” and threaten her if she does not. While her brother can enjoy his childhood, play with his mates, run, and jump as he wishes, she is forbidden from doing so.

In spite of these constraints and prohibitions, the girl decides to study medicine. She is dazzled by the power of science and believes that by studying medical sciences she will be superior to men. She graduates successfully from medical school and starts her medical practice. The young doctor immerses herself in work, and during the long reception hours and home calls, she gets closer to people. Poverty, misery, and the oppression and exploitation of women are her constant companions. She learns from her patients what medical school failed to teach her: that science alone cannot gain access to people’s hearts. Understanding and helping people requires the kind of emotional maturity, communication skills, and competencies that enable a doctor to sympathize with patients and be an empathetic and compassionate caregiver.

For a long time the dedicated doctor ignores her own personal life for the sake of her career. However, when she does try to engage in relationships with men, she experiences, over and over again, their patronizing and even abusive conduct. Shortly after her first marriage, her husband orders her to quit work. He wants his wife to stay at home, clean his house, launder his clothes, and greet him with a hot meal upon his return from work. Again, she refuses to be treated as an object, and the conflict ultimately ends in divorce. The story ends some years later when she meets an educated and caring man and they are married.

The encounter described in the excerpt takes place in Cairo, between the young doctor and a young girl from Upper Egypt (the southern part of Egypt called Sa’id). The young patient comes a long way from home to seek help from an unknown doctor. The girl is hopeless and terrified. Her life depends on one thing: the doctor agreeing to terminate her pregnancy. Fortunately, she is received by a warm, empathic, and kind physician. The doctor could have refused in order to protect herself from personal and professional ruin, but her heart goes out to the girl, and she does not hesitate to break the law and endanger herself to save this patient who needs her help.

For the last six years I have been teaching a literature and medicine course for medical students in Israel. Our students come from diverse cultural, ethnic, and religious backgrounds. They include Jews and Arabs (Muslims, Christians, and Druze), secular and religious. This multiethnic blend reflects the diversity of Israeli society. Memoirs of a Woman Doctor has been translated into many languages, and students in my course are free to read it in either in the Hebrew translation or in the original Arabic language. The story provokes lively discussion among students, and some female students react very emotionally. The themes of oppression against women, the status of a woman doctor, the doctor–patient relationship, and professional versus private life are topics that invite students to reflect on their medical studies, on relations within society, and on their future as physicians. In the last session students are asked to write an essay on one of the works they have read and discussed throughout the course. Some choose to write on Memoirs of a Woman Doctor, and their comments often illustrate the resonant power of El-Saadawi’s story. As one student wrote:

That’s exactly why I decided to study medicine. I wanted to show everybody that a woman can also treat people and cure them, perhaps even better than men. After all, women by their nature are more caring and understanding.

Another student confirmed the wisdom that El-Saadawi’s story imparts to readers, as well as the valuable insight it provides for future physicians:

Nobody can stop me now, because I am the richest person on earth. Now, I know what pain is, and how it looks in the patient’s eyes. I know what crying is, what love is and what empathy is. These all help me provide better treatment for my patients.

© 2012 Association of American Medical Colleges