SPECIAL SECTION

CHAIRMAN’S REFLECTIONS
Part 14

Looking back at the first few years of working as a cardiologist at home in Qatar, is like watching an old movie. The scenes are clear, the events exciting, the struggles intense, and the heroes real. Some characters are still around; some are no longer with us.

                                                                                     H.A. Hajar Albinali*, MD

MY IRAQI FRIEND: KHALID

   A few months before the invasion of Iraq in April 2003, my Iraqi friend, Khalid, called me from Baghdad to tell me that he fainted after an episode of chest pain. I immediately knew the diagnosis and assumed the role of his physician over the telephone and the Internet before he came to Doha for treatment. But before I discuss the medical problem of my friend, my memory is forcing me to go back to Colorado and the first day I met him.
After I graduated from Doha Secondary School in 1964, I was sent on scholarship to the USA to a small junior college in Baytown, Texas. After completing the Fall and Spring semesters, I did not know what to do in the summer. At that time, our government supported only one trip home every two years. I asked the advice of a Texan family. They suggested that I drive to Colorado during the summer vacation as a tourist. Uncertain that I could make such a trip alone, the family convinced me that it would be very easy. They brought a map and marked the route that I should follow with a yellow marker. I settled the rent and slept early that night.
   At five o'clock the following morning, I packed my clothes and the few books I had, dropped them in the car trunk, and started the trip long before the sun rose. I was anxious the first few hours, then gained confidence as I got used to the road. At sunset, I reached New Mexico where I slept and continued the trip at dawn the following day. I reached Boulder, Colorado at 2 PM. I parked my car near the University of Colorado (CU), walked around, and entered a cafeteria. Around a large round table, there was a group of noisy students speaking in Arabic. I greeted them. They all stood up to greet me, a drifting stranger. They invited me to join them and they bought hamburger, French fries, and tea for me. Several students invited me to stay in their apartment until I had settled in Boulder. Since I did not know any of them yet, it was hard for me to decide which invitation to accept.
   One of the students, Khalid, was an Iraqi graduate student who was the president of the Arab Club in Boulder. He told me that his apartment was too small, but suggested that I accept a Saudi student's invitation. The Saudi lived alone in a large apartment. I thanked Khalid for making the decision for me.
  I did not consider going to a hotel for several reasons. First, I did not have enough money to stay in a hotel. In those days, a student received only $200 allowance a month from the government of Qatar. Second, I hated to stay in a hotel alone. The third and most important reason was that I was not used to hotels. As a child growing up in a small town of the Arabian Gulf, the word hotel was unknown to us then. A traveler was a guest of the community. When I accompanied my father on trips, we were always guests of his friends. Rarely did a week pass without guests staying in our house. Most of the traveling guests were men. I do remember traveling women once. I was about seven years old playing in front of our house, near the beach, when a ship anchored in front of our house just before sunset. Five ladies were brought to shore from a ship in a small boat. They walked toward our house. I ran to my mother to inform her that she will have guests. My mother welcomed the strangers. They were traveling from Dubai to Shamal, a summer resort area with palm treegardens in Ras Al Khaiman. They spent the evening in our house as guests. My mother cooked dinner and breakfast for them. The men stayed in the ship because my father was out of town.
   Looking back, life in those days seemed very simple. The Arabs take pride in competing over welcoming a guest. Serving a guest is considered an honor for the Arabs. The Gulf Arab customs and tradition of hospitality that have been transmitted from generation to generation has been complicated by the complexity of modern life. Families used to welcome any person coming to their house as a guest. It is unlikely nowadays, even in the Gulf, for a family to admit strangers in their home, not only because of the availability of hotels but also for security reasons.
From my first day in Boulder the Iraqi student, Khalid, became a very close friend. After a week in Boulder, I fell in love with the place and decided not to go back to Texas. The problem was how could I get accepted in such a big University? I consulted my friend Khalid. He took me to meet Mr. Robert Hofflings, the Dean of Admission. Mr. Hofflings was a very pleasant man. He had worked in the American embassy in Baghdad before.  He had very good relationship with the Arab students at Colorado University (CU). I expressed my desire to transfer from Lee College of Baytown, Texas to the University of Colorado.
   "You come from a small junior college. What makes you think that you could succeed here?" Mr. Hofflings asked, laughing.
"I was a top student in high school and hard working", I replied.
   He stared at me for a while, and then he said: "We will allow you to register for the summer as a non-credit student. If you score high in all the courses, then we will convert you to a regular student in theFall semester." I agreed. Khalid was happy with the offer. I did study very hard during that summer and achieved high grades. I was accepted for the fall.
   During my first year in CU, Khalid was my friend and advisor. I also worked hard with him to organize an Arab day festival for the Arab Club where we showed Americans some aspects of our culture.
   Khalid was a friendly young man, eager to help any person who asked for his help. He was liked and respected by all the Arab students in Boulder as well as the American families associated with the Arab students. The students perceived him with a fatherly image. He was very serious in his social activities and studies. He was sociable but did not attend wild student parties where drinking and dancing predominated. He did not drink alcohol. He did not go out dating girls. He had lived in Moscow for thee years, as a high school student and spoke Russian well, but he never picked up the Russian drinking habit. He kept telling us that his goal was to finish his studies and return home to serve his country. He was an Arab nationalist. His dream of a future Arab unity was always on
his mind.
   One night, I was preparing for an exam in Calculus. There was a very difficult problem that I could not solve. I asked Khalid to help me. He was a graduate student in nuclear physics. He spent one hour explaining to me the steps involved in solving such a difficult problem. Later, I learned that he was preparing for a big exam that night. He did not want me to know that he was very busy with his own exam. He gave priority to his friend's needs over his own.
   After two years, Khalid graduated and returned to Iraq. I was elected as president of the Arab Club in Colorado for the following two years. After my graduation from college in 1969, I visited Khalid in Baghdad. He was my host and tourist guide. Other Iraqi friends who graduated from CU also joined us. With their help and hospitality, I enjoyed my stay in Baghdad very much.

Fig. 1. Baghdad: Bridge over the Tigris River before the 2003 war

   I did not hear from Khalid for the next 30 years until the year 2000, when an Iraqi doctor in Hamad Medical Corporation (HMC) brought me greetings from Khalid and his telephone number. We re-established contact and communicated by phone, letters and email frequently.
In 2002, Khalid wrote me a long email, ending it with news of his family:

   In October 2002, while Khalid was alone in his office late in the afternoon, he had sudden onset of severe chest pain with shortness of breath and sweating. He collapsed unconscious on the floor of his office. When he regained consciousness, he had no pain but felt very weak. He drove to a nearby health clinic. A general practitioner assured him that his symptoms were caused by hard work and that he should rest. A week later, he had recurrent chest pain on walking. He went to see a cardiologist. Coronary angiography in Baghdad revealed severe ostial and mid-LAD stenosis. He was advised medical therapy as the lesion was considered risky and difficult for PTCA. He was treated with Simvastatin, aspirin, and NTG as needed.
   Khalid sent me the information and the angiography images for opinion. I insisted that he should travel to Doha for stenting. He agreed. Because of the embargo on Iraq, he could not travel to Doha directly. On December 15, 2002 he wrote: "I will leave tomorrow from Baghdad to Damascus then to Doha through Cairo". He had to wait 3 days in Cairo for a connecting flight to Doha.
   He came to Doha as my personal guest in my home. I admitted him to our cardiology service for one day on the 21st of December 2002. We repeated the angiography and stented the lesions. I wrote to his cardiologist, who was on the staff in Saddam Center for Cardiac Surgery in Baghdad the following information:

Fig. 2. Dr. Khalid in HMC

has a lesion at the distal part of the PDA 70%. The Ramus is small with diffuse disease.   The right coronary artery is small, non-dominant, and has an insignificant lesion, no more than 40%. We proceeded with first dilation of the proximal LAD at the level of 1st diagonal with 2mm balloon and then with 2.5mm balloon and finally with 2.75mm balloon before implantation of Cypher stent. Then we went to the ostial lesion, dilated it and implanted a 3mm Cypher stent. The procedure was successful. The patient tolerated the procedure well. Dr. Khalid was kept one day in the CCU for observation. During 24 hours he received Agrostat IV infusion. We started him on Plavix 300mg the night before the procedure and then continued on 75mg daily. It was an incidental finding that his ESR was 99 while CBC, RF, ANA and LFT's were normal. A shadow was noted in the left hilar region of the lung. A CT scan revealed an old calcification in the pleura. His ESR decreased to 66, three days later.
   We were concerned about the ESR, but we found out however, that he had fever a week earlier followed by rash. This was diagnosed by a dermatologist in HMC as Herpes Simplex complicated with infection. He is currently under therapy for his skin lesion.

   I gave Khalid the above report to take with him to Baghdad.

   While Khalid was in Doha, he watched on TV one of his colleagues, an Iraqi scientist, talking about his interview with UN inspectors. He told me: "I must go back to Baghdad. I am also on the list of scientists to be interviewed. I do not want them to say I ran away". So, on the 28th of December 2002, he returned to Baghdad.

   In the beginning of January 2003, Khalid's wife who is a Radiologist wrote me: "Happy new year. Abu Walid [Khalid] is back sitting with the children, joking, and laughing with the family. Tears of joy are running from my eyes. We are all happy and thankful to you. I look forward to seeing you and the family".
   Khalid wrote me on 23rd of January 2003: "I felt sad saying good-bye to you after those few days, reminiscing about the old days. I am back to full activity. I started exercising as per your advice. I feel well. Thank you".
   I was in touch with Khalid until three days before the war. During the US-led war on Iraq, I had no communication with Khalid. I prayed for his safety. I was very sad to see the Iraqi civilian victims on TV. I was also sad to see Baghdad pounded with bombs and missiles.
   Baghdad has a special place in Arab and Islamic history. It was the capital of the Arab Empire during the zenith of Arab-Islamic civilization at the time of the Abassid caliphate (AD 758-1258).
   During the war on Iraq this year, I heard on BBC radio a Turkish commentator saying that Baghdad is very dear to the Turks also. He quoted a Turkish saying "No woman is dearer than a mother and no city is dearer than Baghdad."
I wrote several poems about Baghdad during the war between March 20 and April 9, 2003. I published the poems in a book under the title: "Tears over Baghdad".
   On May 5, 2003 while reviewing the draft of my poetry book, Tears over Baghdad, I received a call from Dubai Airport in the UAE. The caller told me: "Your friend Dr. Khalid was killed." I was shocked to hear such bad news. I was very sad the whole day. Tears over Khalid were added to tears over Baghdad. I wrote a poem expressing my feeling about the death of my friend, Khalid. I sent it to the publisher to add it to the book.
   Khalid's son later wrote to me the details surrounding his father's death:
"On April 8 he went to his office to work as usual. When he heard that the American forces had reached inside Baghdad, he decided to go home to stay with his family. Upon reaching the street next to our house, his car was hit with a shell or a rocket. A piece of shrapnel pierced through his head. He realized that he was dying. Before losing consciousness, he pulled his pen and wrote over his left arm. Then, he lost consciousness. He was taken to a hospital with a lot of difficulty because the invading army was firing at any thing that moved in Baghdad then. In the hospital, he expired".
   The family found on his left arm written what every Moslem should say at his time of death: "Ash'hado anna la-ilaha illa-allah, wa' anna Mohammadan rasoolo allah", which means "There is no God but Allah and Mohammed was his prophet."
In my condolence to Khalid's family, I made use of the meaning of the Arabic word "Khalid" in my poem. Khalid means "eternal" or "forever".

Tears flood my eye
When sorrow provoked my cry

O'Khalid's folks, be patient, however,
Nothing but God lasts forever.

Fig. 3. Baghdad burning AD 2003 war