Alaa Al Aswany - Chicago

It’s cold in the operating room; floodlights are trained on the chest of the patient lying there awaiting his fate. The sound of his breathing in the machine and his heartbeats, which are amplified dozens of times, compound the awe of the situation. The surgical team comprises the nurses, the anesthesiologists, and the assistants. Dr. Karam greets them then tells them a joke or something funny at which they laugh in an exaggerated manner to disguise their tension. He follows them as they work, with a scrutinizing look, not without affection, as if he is a maestro watching his musicians playing and awaiting, in accordance with a mysterious internal rhythm, the moment he joins in. When that moment comes, Dr. Karam extends his hand forward with the scalpel, as if inaugurating the show. He turns the scalpel in the air to the right and the left, and then brings it down to the patient’s skin, touching it gently several times as though testing it out. Then suddenly he pounces on it, plunging the blade into the tissues with one deep cut, almost lustful and unbelievable. The blood bursts profusely and the assistants’ hands hurry with suction tubes and dressings. Dr. Karam works slowly, confidently, and calmly with an amazing concentration that makes him the first to warn the anesthesiologist about an almost invisible blueness on the patient’s face, or to notice the eruption of a microscopic drop of blood a full ten seconds before his assistants notice it. During the surgery, everything is done with strict precision: the patient’s heart is taken out and the patient is connected to the artificial heart machine. Then Dr. Karam replaces the patient’s clogged arteries with other ones taken from the leg and tested well outside the body. Then he attaches the new arteries and ultimately he resumes pumping the blood to the heart that he has fixed with his own hands. The operation lasts many hours, during which his hands don’t stop working while the eyes of the assistants are hanging on to the slightest gesture from him, to act upon it immediately. They often understand what he wants before he opens his mouth. With long experience they are able to read his face behind the mask, and so long as he is working in silence it means that everything is all right. If his hands stop working, it means something is wrong. His hoarse voice soon reverberates around the room in a warning dramatic tone as if he were the captain of a ship about to go down—“Operate auxiliary suction,”

“Give him something to raise the pressure,” or “I’ll need another hour.” They all obey him at once; he is the professor, the surgeon, and the experienced skillful leader who shoulders the responsibility for bringing this sleeping patient back to life. The fate of a whole family is now hanging on his ever-moving fingers.

Karam Doss was a truly great surgeon, and like many greats, he was eccentric. For instance, he would always take off his underwear and wear his scrubs directly on top of his naked body, giving him a sense of freedom that also gave his mind clarity and focus. Ever since he headed the surgical team ten years ago he started performing his surgeries listening to Umm Kulthum’s songs, whose voice reverberated in the operating room from speakers that Dr. Karam ordered to be installed in the wall, connected to a stereo in the adjacent room. The scene, though strange, became familiar: the listeners on the tape applauding and shouting so that Umm Kulthum would repeat a phrase of “Inta Umri” (“You Are My Life”) or “Ba‘id ‘Annak” (“Away from You”), saying how great the Sitt was, or screaming in ecstasy when Muhammad Abdu played one of his incomparable solos on the qanun . Dr. Karam would hum softly with the music while busy suturing an artery or cutting more skin and muscle with the scalpel to give himself more room to finish the surgery. He would say that Umm Kulthum’s voice helped calm his nerves while he worked. Amazingly, the American members of his team began to enjoy Umm Kulthum’s voice, or perhaps pretended to in order to please him.

One time, two years ago, an assistant surgeon named Jack joined the team. As soon as Dr. Karam saw him he realized from his long experience in America that he was a bigot. Not long after Jack joined the team, silent skirmishes, intangible, wordless quarrels began to take place between him and Dr. Karam. Jack never laughed at Karam’s jokes and fixed him with long, cold, scrutinizing stares. He also followed his instructions reluctantly, carrying them out in a deliberately slow manner as if telling him, “Yes, I work under you; I’m just an assistant and you’re a big-time surgeon, but don’t you forget that I’m a white American, master of this country, and you’re just a colored Arab who has come from Africa and we have taught you and trained you and made a civilized person out of you.”

Dr. Karam ignored Jack’s provocative gestures and took pains to deal with him in a formal and neutral manner. One day, however, he was surprised to see him come in a few minutes before the operation while he was sterilizing his hands and arms. Jack stood next to him and greeted him curtly then said in a voice choked with confusion and hatred, “Professor Karam, please stop playing those depressing Egyptian songs during surgery, because they prevent me from focusing on my work.”

Karam Doss remained silent, finished the sterilization carefully, and turned toward Jack with his hands raised and his frowning face flushed with anger, looking more like a wise Coptic priest about to dumbfound the wicked with the truth, and said calmly, “Listen, son, I’ve worked very hard for thirty years so that I can have the right to listen to whatever I like in the operating room.”

He advanced a few steps in a manner fraught with meaning, then pushed the door leading to the operating room with his foot and said before disappearing behind it, “You can find a place in another surgery team if you like.”

~~~~~~~~~

THERE IS NOTHING IN KARAM Doss’s life except surgery; it is his job and his great pleasure at the same time. Very simply, he is a workaholic. He has a few friends that he rarely has the time to see. His only pleasure, next to surgery, is a few glasses of whiskey and a good book. He is over sixty and is still unmarried because he doesn’t have the time for all that.

He told his students (when they complained about working long hours) his story about the beautiful Italian woman he met twenty years earlier. They had gone out more than once and they had a good relationship, but it so happened that whenever he was about to sleep with her, he would be called for an emergency. Then there was that one night when things were proceeding as well as could be hoped for: he went with her to her apartment, where they had dinner, had a few drinks, took off their clothes, and actually started to make love. Suddenly his pager emitted that abominable buzz. Karam jumped up, getting off her, then started putting on his clothes in no particular order and began to apologize to her, using moving language about it being his duty to save the life of a person who needed him right away. But he was surprised that she hurled a whole dictionary of Italian insults at him and his parents. Then she got so angry that she started chasing him like a furious, ferocious tigress, which made him run for his life as she threw everything in the room she could lay hands on at him. Dr. Karam would laugh heartily whenever he related the story, but his face would turn serious again as he advised young surgeons, “If you fall in love with surgery, you won’t be able to love anything else.”

Karam Doss’s life, however, despite his loneliness, was not without exciting events, the strangest of which had happened a few years earlier. One evening, as he was about to leave his office after a hard day, he heard the fax machine turn on. He extended his hand to close the office door, intending to read the fax in the morning, but he changed his mind, turned on the light, and took the sheet from the fax machine and read the following: