MENTORSHIP RECIPIENT

Mentor Commentary:
Katie Strine

Recipient Reflection: 
Hania Qutub

The Diagnosis

Creative Non-Fiction by Hania Qutub 

The patient was an ordinary middle-aged woman in her early 50’s, who had come to see me for a common condition, the perimenopause. Hot flashes. Weight gain. Mood changes. I listened to the impact it was having on her life. The disturbance and embarrassment a public hot flash could have. Her anxiety before she knew what she was experiencing. The warmth that seemed to start in her head and rush all the way down to her toes leaving in its wake bright red splotches on her face and neck. The distress of looking in the mirror and feeling the person looking back was someone else. The wakings at night that seemed to come out of nowhere. Bedsheets drenched in sweat. The difficulty falling back asleep.  The morning grogginess. The brain fog. The fatigue and general lack of enthusiasm to do things that seemed effortless before. The asphyxiating fragility of everything and the uncontrollable outbursts that followed. 

“And, oh, Doctor? One more thing,” she said. “My appetite. I’m always hungry! It seems I am ravenous all the time now. I panic if I don’t have a snack handy. I can only go short intervals without craving food.” Typical of women in the menopausal transition, she acknowledged weight gain focused mainly on her waist. “What you are experiencing is very common,” I explained, and we talked more. 

At my desk, I compiled my notes and began entering my diagnoses into the electronic chart. I typed in her symptoms one by one and clicked Enter. I accepted hot flashes, mood swings as they came up. Hyperphagia resulted in nothing. I put a space in the word. Then a hyphen. Nothing. Well maybe a more colloquial term would help. I tried the word hunger. A variety of choices  immediately appeared. Hunger initial, Effects of Hunger, Hunger Sequelae. 

Hunger. Raw and bare on my screen. Staring back at me with all the images it evoked. Children lying on their side in fetal position. Their ribs hugging their skin. Faces with muscle atrophy so severe that they were left with a vacuous stare. Expressionless, having lost  facial muscle. Unable to smile or frown, laugh or cry. Bodies of young and old emaciated as they wasted away, burning their last reserves trying to remain alive. 

Bodies dead of starvation. Starvation inflicted to create a malicious hunger. I wondered how those mothers who attacked the aid convoys entering Gaza could bear to see these photos. Or whether they applauded their criminal lack of mercy. I wondered if that made them feel safer, or stronger or more devout. I wondered if they thought their God was cheering them on as they burned food in trucks and stole water bottles meant to quench 2.3 million parched palates. A 2.3 million that was likely now only 1.5 million. A child drinking from a murky puddle in the street.  Fathers carrying limp starving children. Mothers feeding six year olds with a bottle. A bottle that had saltwater. And newborns being fed watered down lentils because their mother’s breast milk dried because of their own starvation. Dried up because of hunger. Dying because of hunger. Dead. 

And I thought of all those hungry children and how many of them were beyond salvation in a land where there is not going to be any food delivered soon. In a strip of land walled off for 20 years with rows of trucks outside the gates with rotting food blocked from getting inside. In a land where the occupation forces for 20 years counted the number of subsistence calories allowed to each Palestinian. In a land with no clean water for decades. In a land where parents walk 8 to 12 km in the hot sun to stand in line for insufficient food rations. In a land where the Gaza Humanitarian Foundation Distribution Center laid out all the boxes before them at the end of a long narrow outdoor maze. Run! Quickly before the food is gone! In a land where the American aid workers laughed as they shot those who made it to the end, so that they died with bags of flour in their arms. In a world where no one ever asked why 2.3 million people were locked up in a narrow strip with 160 foot thick and 88 meter high cement walls built by a modern colonial enterprise in medieval throwback. At least in medieval times those walled cities were meant to keep out invaders, not keep in the invaded. At least in medieval times there was no aerial bombing by quadcopters, F16, F15 Thunder jets. At least in medieval times their fishermen were not shelled out of existence by naval warships and explosive bearing drones. The Occupiers called it a concentration camp, a toxic slum and entrapped them beginning 55 years ago, each year improving and perfecting their incarceration tools. 

Hunger for my patient meant something completely different than hunger for the Palestinian people. How could one word mean something unpleasant in the exam room and at the same time be catastrophic for an entire people? To us it was a weakness, a demonstration of our excesses, but to them, it is a weapon of destruction especially for young children. The children, for whom baby milk was considered contraband. I guess Hamas hides in formula bottles. The children for whom diapers were not allowed and those who could still walk ambled with rags tied to their waists. The children some of whom shrieked in a desperate final call asking please for a piece of bread, declaring to us their HUNGER. 

I stared at my screen anguished and crumpled all over again. 

A notification flashed on the right upper corner of my screen informing me that my next patient was ready and waiting. My nurse sent me a Chat Message asking if another patient could receive her IV iron today. And the pharmacy wanted to know if I could revise the number of refills on a prescription. 

My fingers erased the word but could not erase the images. 
​
And the day moved on.

Hania Qutub

Hania Qutub is a Palestinian American poet and physician. She has worked in the United States and overseas with Syrian Refugees in Jordan. Her work includes publications in Mondoweiss, Poetry Festival, Rowayat, and is upcoming in Passager.