Saturday, August 1, 2015

Giving Thanks Where It Is Due:

It is not everyday that one wakes up to his name being strung along with a veritable rosary of literary luminaries that starts with Kafka, Balzac and Chekov. That was my good fortune this week when I was advised by a mutual friend, Dr. Rita Giacaman, of Professor Graham Watt’s academic review of my collection of short stories, (‘vignettes’ is a more accurate descriptive,) Chief Complaint: A Country Doctor’s Tales of Life in Galilee (Just World Books, 2015.) The review appears in the August 2015 issue of the British Journal of General Practice. And indeed it is a worthy read for it gives a panoramic view of published works by and about country doctors.

My pleasant surprise was redoubled when I discovered that my reviewer and I share another mutual friend, Dr. Runa Mackay, who was forced by circumstances to become the grand old dame of gynecology and obstetrics in Nazareth’s environs throughout most of the second half of the twentieth century, though at heart she remained always a dedicated pediatrician. Runa also was a staunch convert to public health and a cofounder of the Galilee Society for Health Research and Services, my single most significant professional contribution to my official field of specialization. With the dearth of recognition in Israel of all things Palestinian it is no small compliment to have my book favorably reviewed by a friend of such a local pillar of our profession in Galilee as Dr. Mackay. And the review is made doubly credible by avoiding the morass of the interminable Israel-Palestine conflict. It lays the bare facts relevant to my discourse leaving it up to the reader to reach his/her conclusion.
Thank you Prof. Graham Watt for your unbiased academic insight and analysis and for involving Kafka, Balzac, Chekov, James Harriet and all the others.
Here it is:
Chief Complaint
A Country Doctor’s Tales of Life in Galilee Hatim Kanaaneh

Just World Books, 2015, PB, 256pp, $21.00, 978-1935982340

The ‘Country Doctor’ is one of the most iconic figures in medicine. Kafka and Balzac wrote novels about him (most examples are male), and Chekov based many of his short stories on his experiences and insights as a country doctor.1 John Berger wrote The Fortunate Man, with photographs by Jean Mohr, based on John Sassal, a GP in remote and rural Gloucestershire.2 W Eugene Smith produced a famous photographic and text essay on a country doctor in Kremmling, Colorado, for Life magazine.3 John Bain and Rosie Donovan in Scotland,4 and Tom O’Dowd and Fionn McCann in Ireland,5 recorded many country doctors in photographs. There is a substantial literature of potboilers, doing for country doctors what James Herriot did for country vets in All Creatures Great & Small.
More than any other figure in medicine, country doctors exemplify what Trish Greenhalgh described as:
‘... the internalised, embodied knowledge that comes from years of listening to stories, building relationships, touching the flesh, responding to real or perceived crises, and witnessing the suffering, healing, coping and dying of ordinary folk’.6
Or as Julian Tudor Hart wrote of his patients:
From many direct and indirect contacts, many non-medical through shared activities, schools, shops and gossip, I have come to understand how ignorant I would be if I only knew them as a doctor seeing them when they were ill. It is a compact world, in which integrity and a sense of proportion are more easily retained than in cities, provided that one accepts the multiple faces one must wear in an intimate communal life. There is immense friendliness, much bravery and generosity, a good deal of petty meanness, treachery and servile cowardice — but never indifference.’ 7
The latest addition to this rich strand of medical literature comes from an unexpected source, Dr Hatim Kanaaneh, a Harvard-trained physician who returned to his home village of Arrabah in Galilee. Although over 500 Palestinian villages have been demolished, built on, or covered with pine forest since the creation of the State of Israel in 1948, Arrabah has survived, in the heart of northern Israel, situated west of Galilee, east of Haifa, north of Nazareth, and south of Lebanon.
About 20% of the population of Israel comprises ‘Israeli Arabs’ as they are officially called, but in the north of the country the figure is near to 50%. In the same way that Raja Shehadeh used a series of Palestinian Walks,8 to describe aspects of living under military occupation in the West Bank, Kanaaneh uses a series of presenting, or chief medical complaints in general practice to tell tales of Palestinian lives inside the State of Israel.
Drawing on stories of family, friends, neighbours, and patients, Kanaaneh describes Palestinian society, based largely on family, religion, and working the land. A major recurring theme is how people have adapted to the loss of land and people in 1948 and to the gradual but systematic loss of land since then. Although Kanaaneh returned to Arrabah in 1970, his stories and memories span a longer period, covering Ottoman, British, and now Israeli, rule. Much of the culture will be unfamiliar to western readers but Kanaaneh is a helpful guide, sprinkling the text with definitions and explanations of Arabic words, phrases, sayings and customs.
Kanaaneh’s previous book A Doctor in Galilee: The Life and Struggle of a Palestinian in Israel, recounted his frustrating experiences as the only Arab doctor working in Israel’s Ministry of Health.9 His new book is less angry and more pastoral, letting stories speak for themselves. All human life is here: pregnancies, weddings, and funerals; involving husbands and wives, daughters and sons, relatives and neighbours, at home, or in exile abroad. Conversation, coffee, and cuisine are the staple fare of ordinary life, with music and dance for special events. Many of the themes are familiar, involving the loss of the old ways, the scattering of families, improved health care, new ways of making a living, and so on, but the circumstances are extraordinary, having citizenship but not nationality, in a place where they have always lived. One of the subjects of the stories reflects:
Every Palestinian has a story worth telling. You scratch the surface and there is a treasure trove in every life.
By drawing on a lifetime’s practice as a country doctor, Kanaaneh brings the story of his people to our attention.
1. Coope J. Dr Chekhov. A study in literature and medicine. Isle of Wight: Cross Publishing, 1997.
2. Berger J. A fortunate man. London: Penguin, 1969.
3. Smith WE. Country doctor. New York, NY: Life Magazine, 1948.
4. Donovan R, Bain J. Single-handed: general practitioners in remote and rural areas. Caithness: Whittles Publishing, 2011.
5. Trinity College Dublin. Gallery. General Practice Exhibition May 2012. http://www.medicine. exhibition2012.php (accessed 4 Jul 2015).
6. Greenhalgh, T. Thirty years on from Alma-Ata: Where have we come from? Where are we going?BrJGenPract 2008;58(556):798–804.
7. Hart JT. The Lancet career guide for medical students. London: Lancet Publications, 1973.
8. Shehadeh R. Palestinian walks: notes on a vanishing landscape. London: Profile Books, 2008.
9. Kanaaneh H. A doctor in Galilee: the life and struggle of a Palestinian in Israel. London: Pluto Press, 2008.
Graham Watt,
Norie Miller Professor of General Practice, University of Glasgow, Glasgow.
Graham Watt
General Practice & Primary Care,
1 Horselethill Road, Glasgow G12 9LX, UK.

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