Would You Wait for a Miracle?

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I have a two month old patient, whose bed is way too big for and who hasn’t cried in my presence once. She has blue eyes, which I could barely see through her constantly dilated pupils. Her skin is whiter than snow and colder than ice. She’s not responsive. She has more peripherals connected to her body than a body of that size should handle.

My two month old patient, precious and young as she is, is brain dead.

For a while, my friends and I lamented her young life. She is a person who will never live. She will never utter the words mom, she will never walk, she will never ride a bike. She will never even have solid food. Why was she being kept alive? Why  was she being put in such pain?

The medical aspect in us couldn’t understand the point of keeping life tethered to that girl. It didn’t make any sense. There’s no way she will wake up again. There’s no way she will recover. For all matters and purposes, that girl who has lived for two months exists no more.

But still, her parents kept her alive adorning her bed with rosaries and religious icons as they prayed by her bedside.

“I know it’s over,” I overheard her mom say while crying. “But I’m hoping He’d look down at her and see how such a precious creature she is and help her.”

And the mother would ask us: what will happen if things worked out with her? What will you see? Isn’t she snoring? What is that sound?

We’d answer in a way to stay true to the medicine without squashing her hopes. Hope, in this case, is a double-edged sword.

They were waiting for a miracle. My friends would even chuckle at the thought. But even though I also thought it was absurd, I just felt terribly, terribly sorry for what that mother had to go through, seeing her daughter’s shell in front of her: alive but not.

I’ve been thinking about miracles ever since I was allocated that little girl. While they round on other patients and they reach her case, I often find myself thinking about the miracle she is waiting for. I don’t get miracles. I don’t know if I believe in them. I think I don’t. But if there’s anything about miracles that I’m sure of, it’s that they are unjust.

Then I thought about what I’d do if I had been the father whose daughter was in my patient’s bed, with tubes going out of her in order to keep her alive. My answer would have surely been a resounding: turn it off. Purely medical. Pure electrolytes. Pure CT scans. Pure EEGs. Pure data. Or so I thought.

Today, as I saw that woman crying over her daughter, I didn’t pity her. I was utterly shocked that what she was doing didn’t feel odd. It didn’t feel weak. It didn’t feel like something I would remotely try to ridicule, like many people I’ve encountered would. Because the shocking revelation was that I’m not so sure I can turn it off, in spite of al the data.

Would you?

 

Following Up on Beirut’s Soon-To-Be Destroyed Roman Hippodrome and The Best Way To Save It

Lebanon isn’t a place where much changes in a year. Seriously, if you look at where we were last year around this time and where we are today, you’ll see a lot of similarities. The only exception, perhaps, to our Lebanese reality is real estate, especially when it comes to all the contracting taking place in Downtown Beirut.

More than year ago, I wrote about the Roman Hippodrome that was soon to be destroyed in Beirut (link), in Wadi Bou Jmil next to the Jewish Synagogue. A lot has happened in a year. So courtesy of a piece (link) by Habib Battah, an LAU professor, published by the BBC, an update on Beirut’s Roman Hippodrome is in order:

  • The developer who wants to use the land is Marwan Kheireddine. Sounds familiar? He is a minister in Lebanon’s current government. Way to go for transparency.
  • The project that will see the destruction of the hippodrome is a gated community where only “elite” Lebanese will enter. In other words: you and I are off limits. Unless you can afford paying millions for a Downtown Beirut apartment.
  • According to Kheireddine, the site is not worth preserving. How does he know this? He hired an archeologist who said so. Yes, because such matters are most transparently handled by the people you buy into your service.
  • Kheireddine is offering 4000 squared meters of the land to turn into a museum of sorts that people could access. Because a Roman Hippodrome was meant to be contained within the parking lot of a building, right?
  • Plots around the site in question are said to contain other parts of the stadium and need to be properly excavated as well.
  • There is an immense shortage of archeologists in the country. The job of those archeologists is to make sure such transgressions never happen. But the government doesn’t seem to care about such an issue.
  • Beirut is not the only place where Lebanese archeological heritage is being destroyed left and right carelessly. In fact, what’s happening outside of Beirut in lesser known areas might be worse.
  • Concerned activists are trying their best to halt the development. But there will come a time when they won’t be able to do much anymore.

I remember back in 2005-2006 when a local cafe in Batroun was being built. The initial digging site revealed a Phoenician burial site, sarcophagi and all. People flocked to see what the site was all about. The following day, nothing survived to tell the tale. Today, instead of that entire burial site lies a cafe known for its shisha and its July 2012 drug scandal.

The Best Way To Save The Hippodrome:

Earlier in 2013, hell broke loose twice over ancient ruins in Beirut. The first time was because some henchmen at District S assaulted the same person who wrote the aforementioned BBC article over him taking pictures of the ruins they were busy dismantling to open up Beirut into the new Dubai-esque age (link). The second time was due to Lebanon’s possibly oldest Church getting discovered at another site where a Jean Nouvel hotel was to be built (link).

The discrepancy between the fate of sites one and two is striking. The former is still operation. The latter has been halted. Churches can do miracles? Believe, people.

Arguments about how priceless a monument is, how irreplaceable it is, how silly it is to replace it with a building, how rare it is to find such a thing in Lebanon, how economically profitable it would be to keep it and turn it into an attraction are all useless simply because most people don’t connect to them on a primal level, enough to get them rallied up.

The only way, apparently, to get to a result, force government to get involved and save such sites in Lebanon is to infuse a dose of religion in the stones. The more religious those stones, the more people get rallied up, the less our government can stand quiet as bulldozers raze through the field. Unfortunately for the hippodrome, there doesn’t seem to be an ancient church in its ruins as of now. Let’s hope that changes soon.

The following pictures are all courtesy of the BBC:

The #1 Rule To Get a Job in Lebanon: Have a Religiously-Appropriate Name

Hassan is the name. Let’s play a game of guess his religion in front of an imaginary crowd. I’m not psychotic I swear, although I guess that’s what a psychotic person would say as well.

100% of my fictive crowd say he’s Muslim. Is he Shiite or Sunni? Let’s say our lovely crowd goes 70-30 for Shiite. All are educated guesses, all are well-reasoned choices. I wouldn’t call such thought process sectarian – after all, they were primed to answer. Our imaginary crowd is 100% wrong.

Hassan is not Muslim. Hassan goes to Church every sunday. He is as religious as they go. He is not eccentric enough to have had a name change. You can say he was born that way.

And yet Hassan is sitting around at home, nearing his 30s, unable to find a job just because of the name his parents decided to give him.

The areas he’s searching in, close to home and familiar, are all Christian. But they don’t believe him when they ask about his religion during job interviews, a question that is getting increasingly popular lately. Companies would definitely not admit to this, obviously.

The #1 rule to get a job in Lebanon is, therefore, to have a name that is appropriate religiously to the region you’re applying to. If you’re a Hassan in Jounieh, odds are you will have a terrible time in getting to the point of receiving a paycheck. Of course, other areas in the country are not exactly better.

It wasn’t enough that most of the jobs in the market today are being taken by highly trained and much less salary demanding Syrian incomers.  Lebanese people are having another hurdle develop in front of them lately, apart from all the wastas. Instead of having Lebanese judged by their capacities and qualifications, they are being increasingly judged by the way they pray and, lately, by where they live. And to think I was doubting my friends from Tripoli who were getting increasingly wary of putting up their city of residence on their CVs.

Bass fi a7la men lebnen? 

 

What You May Not Have Known About Abortion & Some Medical Ethical Issues in Lebanon

You’d think class discussing ethics in medical school are the most boring. The truth, however, is that those classes are the only ones capable of engaging the entire class. The sloths wake up because of a rising tone with their classmates. The conservatives rise because the liberals in class are infringing on their beliefs. The liberals get infuriated at everyone else because they just don’t get it. And the physicians giving the lecture sit back and watch.

Pop corn material? You bet.

Because I am receiving my medical training in Lebanon, we have to also deal with certain aspects of Lebanese law pertaining to these issues and to say our laws are bipolar, nonsensical and surprising is an understatement.

  • Abortion:

We all know abortion is illegal in Lebanon. There’s no pro-life, pro-choice debate. Women have no choice when it comes to this. However, did you also know abortion is illegal even when it comes to congenital abnormalities? In other words, it is illegal for a physician to abort a baby in Lebanon if the baby has, for example, Down’s Syndrome or any other defect which would render his life extremely difficult. The only situation in which abortion can be performed in Lebanon legally is when the pregnancy is endangering the mother’s life – and even that comes with its own baggage of morality clauses.

In fact, any physician who performs abortions that are not indicated – even if they are for what many perceive as common sense causes – can be targeted by the law especially if he rubs a prosecutor the wrong way. Some physicians refuse to do abortions fearing legal issues while others refuse to do so for religious issues. In fact, a physician who is training me said to my face: “I wouldn’t even abort my own sister if the baby was a product of rape.” I was outraged but this is how it goes.

Certain major hospitals in the country do not even do amniocentesis, which is a component in prenatal care and diagnosis to detect certain abnormalities. Their argument? We’re not aborting anyway so what’s the point of the mother knowing if the child has Down’s Syndrome or not? Besides, amniocentesis carries a theoretical 1/250 chance of causing a miscarriage – who needs that risk?

A relevant abortion real life story we were told is when a radiologist missed the absent right arm of her fetus, a condition called phocomelia. She later found out of the condition at a gynecologist’s visit and decided to abort. She then wanted to sue the radiologist for missing the condition but was eventually talked out of it because having the case reach a court of law would get both the mother and physician in jail.

  • Gamete donation:

I daresay Lebanon doesn’t need more fertility. If anything, we need to have population control. But some people just need those little bundles of joy in their lives. Some want to because they feel a need to be parents. Others want to because society looks down upon the women who don’t give their husbands children. Many couples resort to In Vitro Fertilization or other methods of Assisted Reproductive Technology. Insurance companies pay for such practices without knowing so because hospitals cover it up in their charts.

For some couples, however, gamete donation is required for them to have children. Yes, the child wouldn’t be theirs biologically but that’s not all that matters now, right?

Here comes the interesting part, Lebanon-style: There’s absolutely nothing – no religious decree, law – allows sperm donation. It doesn’t matter what the man’s fertility status is. It doesn’t matter if the woman is as fertile as they come. Oocyte donation, however, is an entirely different story that is governed by each person’s sect. Meaning: whether or not a person is allowed to donate or receive donated oocyte is correlated with that person’s sectarian personal status. Move over civil marriage, I guess.

Don’t worry though, the sects agree on this. The Christian, Druze and Sunni sects prohibit this. Shiites are the ones who have gone off the rails – but not all of them. Lebanese Shiites fall under two main branches. There are those who follow Mohammad Hussein Fadalallah in their practices while others follow Iran’s Khamenei. Those who follow the latter are not allowed to donate or receive oocytes while those who follow the former can do so as per a fatwa which he issued shortly before his death. The condition? The oocytes have to donated by someone by the man’s other wives.

  • Embryo Research:

Not a lot of research is being done in Lebanon. This is especially lower when it comes to embryo research – the number is zero. However, who would have thought that the law can actually be interpreted in a way that permits such research?

In fact, the Lebanese law pertaining to this issue stipulates that the embryo is a product of conception and can be manipulated as long as both parents agree. Other products of conception include the placenta. This effectively renders the embryo prone for research. So in a way, we are ahead Western countries in this regard.

Why hasn’t this law gained traction? Mainly because no institutions actually allow such forms of research to happen in their premises. Most of the country’s main hospitals are religious institutes at their base. The law has also passed unnoticed by the radar of sects because they’re all busy elsewhere and we still don’t know if it’s been put into effect. Interestingly though, at least some MP members (Kassem Hachem, I believe) tackled the issue at hand. Meanwhile, women are still waiting on their own domestic violence law.

  • Conclusion:

We were asked the following question about frozen embryos: if you freeze an embryo for 5 years and then implant it, is the fetus one day or 5 years old?

All hell would have broken loose if we hadn’t been a small group in the discussion. I guess it doesn’t really matter where we legally stand from such issues. What is clear, at least to me, is that we are lightyears away from having a decent discussion about them. But I still find them fascinating.

Santa Muerte Shrine To Open in Lebanon

Following the outrage of some Lebanese that other Lebanese were outraged at a possible shirtgate involving demonizing a Virgin Mary icon are not aware of well-rooted Mexican folklore, the Mexican embassy, in collaboration with the Lebanese government, will be building a Santa Muerte shrine in the village of DeirBella.

Issuing a brief statement on the matter, the Mexican embassy noted the “overwhelming support” their not-recognized saint has gotten over the past few hours in Lebanon. They were “absolutely dumbfounded” by the well-rooted knowledge of Santa Muerte among the Lebanese populace whereby everyone seems to be quite the expert. “We didn’t know Santa Muerte had so many fans in Lebanon,” they said, “this makes us quite excited about possible culture fusion between the countries.” The embassy was also quite “enthusiastic” about the culture fusion prospect in Lebanese society, à la St. Patrick’s Day and Thanksgiving.

“It shouldn’t be exclusive to the Irish and the Americans, now should it?” They said.

A date to celebrate the Day of the Dead is still being debated. They’re not sure if it fits with all the Halloween parties that will take place on October 31st.

The Lebanese government, on the other hand, sees this step as another confirmation of the deep ties between Lebanon and Mexico where a sizable expat population could be found. They find the building of the Santa Muerte shrine will strengthen the relation between the two countries, giving both expats and Lebanese residents a taste of Mexican lore. The government noted the choice of location as somewhere that has a Spanish flare in its name so Santa Muerte feels right at home.

Seeing as Santa Muerte is not recognized by both the Catholic Church and the Mexican Catholic Church, both governments have teamed up with country-gone-pop singer Taylor Swift in order to record an anthem taking a jab at the inadequacy of the Catholic Church and the ignorance of those who don’t know Santa Muerte outside of its natural habitat. The initial leaked lyrics read the following:

I remember when Pope Francis was elected, last month
We said this is it, now’s our shot
Cause like he wasn’t wearing a fancy robe
When he waved his one Argentinian hand
Then he came around again and said
Minions, Santa Muerte will not be recognized ever
And all of you have to deal with it
God Bless those who don’t know it exists.

Oh, Santa Muerte called me up last night and said
The Catholic Church and I are never ever ever getting together
We are never ever ever getting together
They can talk to their minions, talk to their friends, talk to me
But the Catholic Church and I are never ever ever getting together
Like, ever!

We are not entirely sure about the hit potential of the above song but rumor has it Najwa Karam was enlisted to write the accomagnying Arabic version. Her latest tweets have all been of the anthem’s possible lyrics: “Albi fata7, seret shouf, Santa Muerte ejet.”

Meanwhile, research is underway at the American University of Beirut between psychologist Thomas Renecamp and philosopher Patrick Henderson. This rare collaboration between these often-diverging sciences is centered around the peculiar reaction that was observed following ShirtGate whereby Lebanese people established a duality of freedom of expression. They are trying to understand the dynamics behind calling other people ignorant and condescending because of a simple disagreement of opinion. “Freedom of expression seems to go only one way only in Lebanon,” Henderson said. “If your opinion isn’t that of the cool people, then your opinion is automatically relegated to something subpar compared to the other self-proclaimed wise men and women.”

They are also working on a hierarchy of ignorance whereby different levels of the entity will be categorized as they have found the term to be thrown around very loosely.
“Not sure if an English word or a prostitute,” professor Renecamp was heard saying in typical German candidness.

If you feel like participating in their research, you can email TR8656@aub.edu.lb and PH7.13@aub.edu.lb.

The Maronite and Catholic Churches in Lebanon have yet to take any measures due to the Patriarch being on a European road trip for the next month and a half.
The shrine in question is set to open on April 31st, 2013.

My Salafist Friend

I was one of those people who, less than a year ago, equated Salafism with extremism. They were all bearded freaks who wanted nothing else but to establish the Islamist Republic of Lebanon and either kick me out of my home in the process or tax me for just being here.

It’s definitely a misconception. But can you really blame me? After all, the only thing I see of Salafists are those extremists who burn tires and talk endlessly about the struggle of Sunnis in Lebanon.

All of that changed when I got to know M. some more. I won’t say his full name and that’s not even his initial, just in case. He’s my colleague in medical school and I knew he was a devout Muslim but never knew he was a Salafist until he told me.

There he was: no beard, no robe, no constant angry rants about how Lebanon’s Sunnis should reign supreme even though he senses inequality in this country regarding his people, which is definitely not a work of fiction.

And I was taken off guard. This man was challenging every misconception I had about those people I had grown to be disgusted by and he was doing so not by trying to convince me about them not being as bad as they appear to be but simply by existing in the front row of our classroom.

M. later on gave me my pet cat. He didn’t ask for money for it – he simply had two Persian cats who like to reproduce and decided I should have one. Here’s how Katniss looks like today (link).

M. even read the many posts I had written about the reaction to The Innocence of Muslims and was even supportive of the content that criticized the very people that are associated with his branch of Sunni Islam.

M. is always the first Muslim of my friends who texts me on our religious holidays. Whether he’s traveling to Kuwait or in his home in Beirut, I can always expect a heart-warming greeting message. And the texts are not just addressed to me. He sends a personalized one to every Christian he knows. The more “moderate” Muslims I know and with whom I may be an even closer friend don’t do that. The Christians I know rarely text greetings as well.

Back in July, during a month we had as a clerkship at St. George’ Hospital in Achrafieh, we decided to have a group lunch at one of the nearby restaurants. It was there that we discussed his religious views. He explained that Salafism is one of many branches in Sunni Islam, sort of like those sects we have under the umbrella in Christianity. He explained that they differ with others in that they have a stricter view of the Quran. He told me about the struggles he has on daily basis while trying to reconcile his faith with the way of life. His worry at the time was that he cannot shake the hands of women at the hospital and is worried they would be offended.
To many, his struggle borderlines on the absurd. But who was I to judge?

M. doesn’t shove his religious views down everyone’s throat like other people in class do. In fact, he is often ridiculed by other students and even some doctors for asking about the benefits of abstinence in preventing some types of cancers and other diseases.

M. doesn’t believe that Christians should be second-class citizens in Lebanon. He believes they should not only be first-class citizens but if there’s only one A-class, they should be it. Why? Because he says they are the reason Lebanon isn’t more screwed up than it currently is and is different from our neighboring countries.

M. doesn’t believe the Islamic Sharia should be applied in Lebanon even though he doesn’t oppose it. And even though ideally he would like to live in a place where the Sharia is enforced, he says he will be the first Muslim to oppose such a thing happening in Lebanon because “we don’t live here alone.”

M. is actually with optional civil marriage in Lebanon. He was against it at first but after discussing the issue, he decided it wasn’t his place to enforce his views on everyone even though he doesn’t like the idea of civil marriage to begin with.

M. understands why the Orthodox Law came to exist. He comprehends the reasons that sparked such a law from becoming in the forefront of discussions. And he said he doesn’t mind if the law passes, although ideally he would prefer something less divisive.

After my daily encounters with M., I became a person who separates between Salafism and extremism. Salafism is a religious current that even Christianity has a counterpart for (Evangelicals in case you were wondering). Extremism is something that transcends religions and sects: we have it, they have it, everyone has it. Those Christians who hate Mohammads because they think they are the root of all the woes in the country are extremists. The Sunnis who turned Salafism into a taboo are extremists. The governmental policy which almost turned Salafism into a crime is an extremist.

My friend M. the Salafist, however, extremist he is not.

Could Patriarch Raï Become The Next Pope?

The conclave of Cardinals in charge of electing the new pope to replace Benedict XVI is currently underway at the Sistine chapel in the Vatican. You’re out of luck if you are a Roman tourist at this time of year – you can blame Benedict’s old age for that.

As it is with papal elections, there is no clear frontrunner as of this point. The myth goes that the cardinals leave their choice to the holy spirit through copious amounts of prayers and holiness. That is if you believe the holy spirit is a combination of politics, geographic, demographics and whatnot.

Eventually, any Pope nowadays is chosen based on one premise only: strengthening the position of the Catholic Church around the world. The late pope John Paul II led one of the biggest developments the Catholic Church had seen when it comes to the Youth, especially in popularity. Benedict’s undeclared job was to contain this surge that John Paul caused in a more Christian, usable, framework.

Today, the Catholic church is stuck at the edge of a steep cliff with the following predicaments:

  1. Decreasing worshippers across the world,
  2. Rise in Christian persecution in certain parts of the world,
  3. Sex-related scandals that plague Catholic priests more often than none,
  4. Corruption scandals that always seem to find a foothold,
  5. The issues of abortion, same-sex marriage and other thorny issues.

Seeing as the Catholic church is firm in its position regarding abortion, same-sex marriages (despite some recent breakthroughs in that regard), stem cell research and the like, I believe point #5 is not even an option in the voters’ mindset. Corruption and sex-related scandals are issues that Cardinals feel should be best kept in-house, not influencing the decision of choosing a Pope who will lead a Church not only based on those two criteria. The stances of the Catholic church regarding the many sex abuse cases that were revealed is a testament to that – if anything, it reminds me of typical elderly Lebanese women whose job in life is to cover up any wrongdoing in their family and showcase it to the world in positive light. Cardinals are similar to those elderly women in that regard.

The most important framework for Cardinals voting today is the following: help Christians around the world stay Christians and lessen the numbers of Christians who are deciding not to be so anymore. There’s little that a Pope can do when it comes to decreasing worshippers – after all, how do you convince people who lack faith that they should have it? It’s impossible. But what the papal conclave of Cardinals can affect is the persecution of Christian minorities across the world, notably in the Middle East.

Pope Benedict’s XVI’s visit to Lebanon back in September – his last major visit to any country before his resignation – was not out of the blue. Him demanding Patriarch Raï to go to Syria and hold mass there, which sparked an insane reaction, was also not out of the blue. Small steps they may be, sure, but for the faithful who still cling to their belief despite the hardships, a patriarch or a Pope acknowledging their strife is some very important business.

The question, therefore, asks itself: Could Patriarch Raï be the dark horse to be elected as the upcoming Pope?

Many Lebanese have already set Facebook pages to that effect, out of enthusiasm mostly, as if a liking a Facebook page to demand our patriarch be instated as Pope is actually beneficial or worth it. But that’s how things are with us – we always take things to Facebook.

However, I have thought about it lately and come to conclude that Mr. Raï could have a decent, albeit slight chance, at becoming the world’s next Pope for the following reasons:

  1. If the main focus is to target the persecution of Christians in the world, what better option than the head of the Christian majority in the location where Christians are targeted the most? The Middle East.
  2. Former pope Benedict’s XVI’s visit to Lebanon was, in part, to sign the Post-Synodal Apostolic Exhortation (text) in which the Vatican goes on and on about the crucial importance of the Church in the Middle East.
  3. A Pope from the Middle East would set the wheels for true Muslim-Christian dialogue, which is what this deeply religious and troubled region needs and the Vatican knows this.
  4. Patriarch Raï is age appropriate to be pope. He is only 73. He also speaks several languages fluently, as is required of Lebanese bishops.
  5. Patriarch Raï does not come from a country where priest sex scandals are aplenty and being relatively unknown to the vote has a rather “cleaner” slate than his counterparts. He was also elected as an assistant to the interim Pope over the past week.

The reasons may not be supremely compelling to have someone become Pope, sure. But they’re still viable enough to put Mr. Raï on the papal map. I’m not even sure if Mr. Raï can be a good pope but he might become one.  And frankly, him getting elected sort of scares me.