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Showing posts with label Other Blogs. Show all posts
Showing posts with label Other Blogs. Show all posts

Sunday, November 12, 2023

Genocide in Gaza: A call to urgent global action:

Genocide in Gaza: A call for urgent global action | Israel-Palestine conflict


Since that letter was released, the situation in Gaza has only gotten worse. The death toll has passed 11,000, while some 2,650 individuals, including approximately 1,400 children, are reported missing, potentially trapped or deceased beneath the rubble. Tens of thousands of wounded are overwhelming struggling medical facilities. The humanitarian situation has reached horrific levels, compounded by the lack of food, water, fuel and electricity.

To understand what is transpiring in Gaza, we must turn to the key legal frameworks that define genocide: Article 6 of the Rome Statute for the International Criminal Court and Article 2 of the Genocide Convention.

According to these documents, genocide involves acts committed with the specific intent to destroy, either in whole or in part, a national, ethnic, racial, or religious group. These acts encompass killing members of the group, causing them serious harm, and imposing conditions of life aimed at physical destruction of the group in whole or in part, among other underlying acts. Notably, the people targeted can be a geographically limited part of the group.

Gaza’s devastating reality mirrors these components of genocide. Despite claiming to target only Hamas, Israel is engaged in an all-out assault on the whole population of Gaza. In just the first week of its relentless assault, it dropped more than 6,000 bombs on the Strip – nearly as many as the United States used in Afghanistan in a full year.

Using high-impact munitions in one of the most densely populated places in the world inevitably leads to a high death toll among civilians, as we have witnessed already in Gaza. In a month, the Israeli bombardment has killed more than 4,400 children and 2,900 women, with many of the men in these horrific statistics also non-combatants.

The Israeli army has also dropped any pretence to “precision strikes”, as its spokesperson Daniel Hagari said its emphasis is “on damage and not accuracy”.


It has also mass-targeted civilian buildings, including hospitals and schools sheltering the displaced. It has bombed residential buildings, wiping out whole families from the population registrar; more than 45 percent of homes were destroyed or damaged, many of them in the supposed “safe areas” of the south where the Israeli army had instructed Palestinians to evacuate to.

This mass killing of civilians is accompanied by the imposition of life conditions aimed clearly at the physical destruction of the Palestinian people. Israel has put Gaza under complete siege, with “no electricity, no food, no water, no gas”, as declared by Israeli Defence Minister Yoav Gallant.

Israel’s bombing of hospitals, the targeting of their solar panels and the blocking of fuel deliveries indicate an intent to prevent Palestinians from accessing life-saving healthcare. More than one-third of hospitals and two-thirds of primary healthcare in Gaza have already shut down.

The Israeli refusal to allow adequate amounts of much-needed humanitarian aid – including food and water – indicates it is willing to allow the Palestinian population to succumb to starvation and disease.

Israeli government and military officials have also verbalised their genocidal intent towards the Palestinian people. On October 9, when announcing the full blockade, Gallant described the 2.3 million people in Gaza as “human animals”. On October 29, Israeli Prime Minister Benjamin Netanyahu used Judaic scripture to justify the killing of Palestinians. “You must remember what Amalek did to you, says our Holy Bible,” he said, quoting a verse that goes on to say: “Now go and smite Amalek … kill both man and woman, infant.”

On November 5, Heritage Minister Amihai Eliyahu said one of Israel’s options in Gaza is to drop a nuclear bomb. He also explained that no humanitarian aid should be provided to Palestinian civilians as “there is no such thing as uninvolved civilians in Gaza”. While his statement faced criticism from Israeli officials, the concerns raised were primarily centred around the potential impact on “Israel’s image” rather than acknowledging the grave implications of such remarks as a potential tool of genocide.

There has been a litany of other official statements employing dehumanising language towards Palestinians, along with incitement by common Israelis for the “annihilation of Gaza”. These reveal the intent to commit war crimes, crimes against humanity, and, indeed, genocide.


In the words of genocide expert and survivor of the Bosnian genocide, Arnessa Buljusmic-Kastura, “That sort of rhetoric is not uncommon when it comes to cases of genocide. It is obviously one of the most important stages when you really consider it, and to hear the openly dehumanising language spoken with so much fervour in the media from government leaders, and from regular people too, is horrifying and it all leads us to where we are at right now, which is the fact that what is happening in Gaza is a genocide.”

While what is happening in Gaza shares common features with other previous situations of genocide, there are also particular elements unique to it. Among these distinct features are the enduring occupation of Palestinian lands, the relentless siege on Gaza, and the staggering proportion of the Palestinian nation already displaced by previous acts of ethnic cleansing.

Additionally, at the heart of this tragedy lies a discourse of dehumanisation, serving both as a strategy and an outcome. The longstanding anti-Palestinian discourse, ongoing since the inception of Zionism, has systematically denied the existence and the rights of Palestinians. The narrative of Israel as “a land without a people, for a people without a land” has effectively erased an entire indigenous population, along with its history, heritage, and grievances.

In parallel, Palestinians have been systematically demonised through narratives that portray them as terrorists, anti-Semites, and even Nazis. Evoking absurd claims of the “Nazification of Palestinians”, Israel, a powerful settler colonial state that has presided over the longest occupation in modern history, is trying to depict itself as a victim; its tormentor – the people it has systematically oppressed and dispossessed for decades.

It is imperative to grasp these distinct aspects of the unfolding genocide in Gaza, as we confront and respond to it. We must not forget that what is happening now is part of a long history of Israeli actions against the Palestinians, extending beyond the Gaza Strip, with genocidal intent and practices targeting other Palestinian communities


We must not forget it as Israel and its allies try to decontextualise what is going on in Gaza and portray it as a war “provoked” by Hamas’s October 7 attack.

Talk about self-defence for Israel is dominating Western rhetoric, with minimal consideration for human lives and adherence to the rules of armed conflict, let alone the 56-year military occupation and 16-year siege of Gaza. This constitutes a fundamental flaw in the appraisal of these events, and, consequently, the ability to address their root causes, as subtly alluded to by UN Secretary-General Antonio Guterres in his October 24 address to the Security Council.

The lessons of the Holocaust were meant to serve as safeguards against state violence and genocide, particularly for vulnerable groups. What we are witnessing today, however, is an unprecedented global dehumanisation campaign against the Palestinians, pushing their narratives, experiences, and histories to the margins.

Historically, the initiation of such campaigns has often been a precursor to genocide. Therefore, it is imperative to restore the Palestinian people’s humanity and recognise their shared history and rights, as a people, as we push for an immediate cessation of the unfolding genocide.

We are witnessing a rapidly growing anti-Palestinian sentiment not only in Israel but also in many European countries, clearly visible in how the authorities are dealing with demonstrations and support for the Palestinian people. It is incumbent upon the international community to address this hatred with the same vigour as it has addressed anti-Semitism.

While the 1949 Geneva Conventions require all state parties “to respect and ensure respect” of these conventions in all circumstances, the Genocide Convention places a legal obligation on every member state to prevent and punish even the attempt to commit this heinous crime, without waiting for it to fully manifest.

“Never again” was meant to be a warning for future generations, yet we have seen genocides occur since the Holocaust, met with global silence. It is time to make “never again” a living principle, an urgent call to action.

In Gaza, “never again” is now.


Wednesday, July 26, 2023

History, art and literature from my twitter



Irish Family Eating a Meal of Potatoes and Milk, 1917. The "Irish" potato is not originally from Ireland but from South America (specifically Peru and Bolivia), where the Indigenous people have been growing it for thousands of years. After the Spanish conquistadors invaded the region during the 16th century, they brought the potato back to Europe where it eventually became a popular food crop by the 19th century. During the 1840s, a potato blight began to infect all the potatoes throughout Europe. The Irish were hit particularly hard because they almost solely subsisted on potatoes. They were mostly tenant farmers who were allocated a small plot of land in return for working on the lands of their landlords. Potatoes were easy to grow in a small area and were cheap, filling, and less prone to spoilage, so it became the perfect food source for the poor. At the height of the Irish famine in 1847, the British landowners continued the exportation of food from Ireland to England and Scotland, which only exacerbated the situation. England refused to enact any sort of export ban. Approximately 1 million Irish people died due to starvation. In the same year, the Choctaw people managed to scrape together $170 (worth $4,800 today) to send to Ireland for famine relief. Just 16 years prior, the Choctaw had been removed from their lands and made to walk the "Trail of Tears" in which as many as 4,000 men, women, and children died due to starvation, disease, and exposure. The Ottoman Empire also sent ships stocked with food but were turned away by the British. They had to covertly transport their supplies into a small town, 70 miles north of Dublin, in order to feed the starving Irish. Sultan Abdulmeiid I also offered to donate 10,000 British pounds (worth $1.3 million today), but Queen Victoria refused to accept as she had already donated 2,000 British pounds and did not want to lose face. The sultan begrudgingly lowered his offer to 1,000 British pounds.
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 The wind cuts through my threadbare coat, my fragile body huddled in the grimy alleyway, eyes locked on the posh restaurant across the street. Crystal chandeliers twinkle, laughter rings out, the scent of rich food wafts towards me, an unwelcome reminder of my gnawing hunger.

I clutch the tattered rugs tightly, remnants of a life that was, each thread a memory of little Sammy and Teddy. They're gone now, taken by the cold grip of hunger, their faces forever etched in my heart. Their spirits remain, little whispers on the wind, forever with me. "Look, Ellie," Sammy's voice, tender as a summer breeze, floats in my ear, "They're eating ice cream, and it's so cold!" "Yes, Sammy," I respond quietly, a bitter smile crossing my chapped lips. "They're different from us, you see. For them, eating ice cream in winter is an adventure, a luxury." Teddy, the quiet observer, speaks next, his voice barely above a whisper. "Do they know, Ellie? About us, I mean." A lump forms in my throat, the unfairness of it all threatening to drown me. "No, Teddy," I reply, my voice a hoarse whisper. "They don't see us." I feel a cold hand on mine, a phantom touch of comfort. Sammy again. "But you see us, Ellie. You always did." I nod, hot tears streaming down my face. "I saw you. I see you. And I'm so sorry...I tried to save you, to protect you..." "You did, Ellie," Teddy interrupts, his voice filled with a wisdom no five-year-old should possess. "It's not your fault." "But I should've..." I protest. "Ellie," Sammy's voice is soft, "Remember the stories you used to tell us? About the moon and stars and how they look after lost children?" I nod, the memory stinging. "Yes, I remember." "Well," Sammy's voice is growing fainter, "we're with them now. And they'll look after us, just like you did. We're not hungry anymore." "And we'll look after you too, Ellie," Teddy adds. "You're not alone." I close my eyes, their words a soothing balm. I am not alone. But I am invisible, just like they were. To the world beyond the alleyway, we don't exist. And yet, we do. We're survivors, battling each day, each moment, trying to find a semblance of hope in this unforgiving city. As the night deepens, I hold onto their memory, their voices a stark reminder of the world's indifference. Yet, within me, a spark flickers, a determination. My life, however difficult, however unnoticed, is not pointless. For Sammy and Teddy, for all the unseen children of this city, of this world, I will continue. I am their voice, their memory. And one day, I vow, we will be invisible no more.
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Monday, May 01, 2023

قرأت لك..عيد بطعم الدموع و رائحة البارود

 الخرطوم د/عبدالعاطي المناعي



هلت أيام عيد الفطر المبارك، بنفحات الفرح الممزوجة بالدموع وبالألم والمعاناة من الحرب التي لم تأتي إلا بالقتل والدمار ورائحة البارود التي منعت ملايين من الشعب السوداني في الداخل والخارج من الفرح او السعادة لما تمر به السودان من احداث عصيبة جدا وغير مسبوقة ففي ظل الحرب والظروف الاقتصادية الصعبة جدا عالميا واقليميا ومحليا انتزعت البسمة من شفاه الكثيرين، ولم يحلّ العيد عند البعض حتى بـ"العافية"، فهو مجرد تقليب للمواجع وتجديد للأحزان وتذكّر لأبناء وأشقّاء وأهل وأقارب وأصدقاء ابتلعتهم احداث 2019 وحاليا من جراء الحرب الي نراها ونشاهدها جميعنا ، لتتسلّل في زحمة الحزن تهاني خجولة بالعيد.


 استقبل السودانيون عيد الفطر دون توقف للحرب، كما أن الفقر أيضا لم يترك بابا إلا دقه، فمع حلول عيد الفطر تنهش متطلبات العيد ما تبقى من منازل الناس بعد سنوات من عدم الاستقرار الاقتصادي وحصار دولي انهك البلد واهله مما ادي الي زيادة البطالة بين الشباب وتردي الاوضاع علي كافة المستويات.


ان تفاقم الأوضاع زاد من وجاع السودانيين وأثقل كاهلهم وحرمهم من جميع المناسبات والأفراح، حيث عاش السودانيون شهر رمضان في ظل ظروف معيشية وسياسية وأمنية واقتصادية صعبة واستثنائية تمر بها بلادهم، أدت لغياب الابتسامة والفرحة وسط ترقب لمفاوضات استمرت لشهور دون الوصول الي حل .  .  شاهدت تسابق السودانيون كبقية الشعوب العربية العيد بأيام لشراء حاجياتهم ومستلزماتهم من خزين رمضان  ومكسرات وملابس وعطور وكل الحاجيات المرافقة لذلك.


ومرت الايام حتي حدث ما حدث مما حول هذا البلد الكريم الامن الي واحة اقتتال ضاعت فيها بسمة الصغار والكبار بسبب ما يحدث من احداث ما كنت اتمناها للبلد الشقيق الذي زرته عشرات المرات واحببته واحببت شعبه الطيب المضياف – ما كنت اتمني ان اري السودان فيما رأيت وعشت فانا الان علي ارضه وتحت سمائه ابتهل الي الله مع اشقائي السودانيين ان تقف الحرب وتلتئم الجراح وليس ذلك علي الله ببعيد.


طوال ايام الحرب وانا اسمع اصوات طلقات الرصاص وازيز الطائرات وطلقات المدافع والصواريخ صباحا ومساء حتي انني كنت احرص علي وضوئي دائما لأنني كنت ولا زلت غير امن من قذيفة من هنا او من هناك كعشرات القذائف التي اودت بكثير من الشهداء وهم في بيوتهم آمنين.


علي مدار اليوم اتابع عبر شاشات التلفاز المحلية والدولية ومن خلال منصات التواصل الاجتماعي بصدقها وبعكسه ما تتناقله من أخبار آملا ان اجد خبرا تتوقف فيه الحرب قبل العيد حقنا لدماء الاشقاء.


حتي جاء العيد الحزين علي السودانيين وانا بينهم حزين لحزنهم ولما الت اليه الاحداث المؤسفة ،عيد غلّفه ثوب حداد قاتم، وبدلا من تلقي باقات التهاني بحلول عيد الفطر، ما زالت الخرطوم تتلقى أنباء ارتفاع أعداد قتلى هنا وهناك مدنيين وعسكريين حتي الاطقم الطبية لم تسلم من ويلات الحرب فاستشهد 11 من الاطباء حتي كتابة هذه السطور إضافة الي خروج عدد كبير يمثل ثلاثة ارباع مستشفيات العاصمة من الخدمة نتيجة اصابات مباشرة أو عدم توافر المياه والكهرباء نتيجة الحرب الدائرة بنارها وحرها.

فاقتصرت صلاة العيد لغالبية سكان الخرطوم في تجمعات قريبة من البيوت، وقد كان بعضهم يحرص على التلاقي صباح العيد للصلاة في الساحات الشهيرة كسابق عهدي حين حضرت العيد في السودان سابقا 2010.

كان شكل العيد بكل تأكيد حينها بطعم مختلف تملؤه السعادة والفرحة والبسمات علي شفاه الصغار والكبار.


 - لكن وللأسف جاء عيد السودانيين هذه المرة مضرجا بالدماء، كان عيدا مكفهرا اختفت فيه مظاهر الفرح المعهودة في مجتمع السودان الكريم الودود - وحتي في اصعب اللحظات كتلك التي اعيشها الان بقدر الله هاتفني الكثير من اصدقائي السودانيين طالبين ان الحق بهم في ولايات غير الخرطوم حتي تستقر الاوضاع.

 فاعتذرت لهم شاكرا كرمهم المعهود واخرين يطلبون ان اقيم معهم في منازلهم حتي لا اكون وحدي بحكم الظروف وشكرت رقي كرمهم المعهود.

معللا لهم بأنني هنا وسط اهلي واصدقائي فربما يحتاج لي مريض هنا او هناك فاقدم له ما استطيع من خدمة طبية أو توجيه صحي فأكون اديت واجبي كطبيب يسعي لان يجابه الموت ويسقي شجرة الحياة بما استطاع والله وحده الذي يسبب الاسباب وهو رب الموت وواهب الحياة.

خليط من الشقاوة والإصرار يبدوان على عيون أطفال عيد السودان الذين كنت اظن أنهم لا يدركون ما جرى، لكن كنت اطمئن علي احد اصدقائي فسالته عن حال اطفاله فقال لي ابنته قالت له ( يا بابا وين العيد لمن رات الناس تعيد في التليفزيون وبكت وابكتنا ) الاطفال من حقهم ان يسعدوا بالعيد وان يلبسوا الجديد وان يتلمسوا من الفرحة انساما ولو في ايام العيد  لكنك تسمع صراخهم المتقطع في الدروب من اطفال جيراني وأشفق علي كل ام بماذا تجيب حين يسالها ابنها الصغير لماذا كل هذا وأين نحن من العيد. 

Tuesday, April 04, 2023

لقد دخلت الحرب جسدي أيضا!

 

الحرب والعجز عن الكتابة

الكاتبة الأوكرانية تانيا ماليارتشوك تناضل في عملها من أجل هوية وطنها. وتكريماً لها على ذلك، حصلت ماليارتشوك على جائزة "يوزيدوم" للأدب لعام 2022. لكنها لم تعُد قادرة على الكتابة منذ اندلاع الحرب. حوار حول قوة الكلمة.



كتبت الكاتبة الأوكرانية تانيا مالارتشوك، التي تعيش في فيينا بعد الغارة الروسية على أوكرانيا في 24 فبراير 2022: «لقد دخلت الحرب جسدي أيضا» - وهو التاريخ الذي سيتم حفره لنا في 1 سبتمبر 1939، «الدبابات الروسية تتقدم وتحتل قلبي ومعدتي وقدمي. هناك وعي ببطء بأن ما حدث للتو على المدى الطويل سيحدد مستقبلي ومستقبل أبناء وطني ، وأنه إذا نجونا من هذا ، فسيتعين علينا التعامل معه لعقود قادمة. لم أعد كاتبة وقد لا أتمكن أبدا من أن أكون كاتبة مرة أخرى. الكلمات التي بداخلي تصلب ، تموت ، تهلك مع كل صاروخ قادم يصطدم بعالمي وينفخه بعيدا ". (اقتباس من صحيفة فرانكفورتر، 20.3.2022.)

Quote by The Frankfurter Allgemeine Sonntagszeitung, 20.3.2022.)

Tuesday, March 07, 2023

NEW BOOK: A Surgeon and a Maverick: The Life and Pioneering Work of Magdi Yacoub

 A Surgeon and a Maverick: The Life and Pioneering Work of Magdi Yacoub

By Simon Pearson, Fiona Gorman, Mary Archer (Foreword by)

 



The incredible life story of a legendary cardiac surgeon and scientist Magdi Yacoub, an outsider who succeeded against the odds. 

Veteran journalists Simon Pearson and Fiona Gorman follow the remarkable life of heart surgeon Magdi Yacoub from his formative years in Egypt, through spectacular success at Cairo University, to his long and distinguished career in Britain. Although at times he clashed with the medical establishment in London, Yacoub pioneered great advances in heart surgery. He was knighted in 1992, and in 2014, he was awarded the highest honor in the gift of the Queen, the Order of Merit.

Written with unprecedented access and drawing on extensive interviews and research, the biography recounts how Yacoub transformed the treatment of children with congenital heart disease. He performed some of the first heart transplants in Britain and the first heart-lung transplants in Europe. At London's Harefield Hospital, he created the greatest heart transplant center in the world. Among his patients are men and women who are still thriving more than thirty-five years after he gave them new hope.

This story is also about science, the development of new medical techniques, and a deeper understanding of how the human body works. Today, at an age when most people have long since retired, Yacoub is still pushing the boundaries of scientific understanding and surgical know-how. He is also taking heart surgery to places that until now have had little access to cardiac treatment, developing centers of excellence across Africa, including in Egypt, where his hospital in Aswan has an international reputation, and a new center is rising in Cairo.

Yacoub's life is one of triumph and tragedy, success and failure, fierce criticism and high praise--it is also an enthralling journey through the worlds of scientific research and medical politics and ethics at the highest levels.

The author Simon Pearson and Fiona Gorman are a husband-and-wife team of author-editors who worked for The Times newspaper in London for more than thirty years. A former executive editor at The Times, Simon is the author of three books, including the bestselling biography The Great Escaper. Fiona has written on a range of subjects including mental health, and Simon contributes obituaries for The Times. They live in London. Dame Mary Archer is a British scientist specializing in solar power conversion. In 2012 she was appointed Dame Commander of the British Empire (DBE) for her services to the National Health Service.

ISBN: 9781649031969
ISBN-10: 1649031963
Publisher: American University in Cairo Press
Publication Date: July 25th, 2023
Pages: 416
Language: English


Editorial Reviews

"This is a story of a life well lived. Sir Magdi Yacoub has transformed medical practice and improved the lives of millions of people. He did this with intellectual creativity, determination, and a deep commitment to serving humanity."—Minouche Shafik, London School of Economics and Political Science

PRAISE FOR MAGDI YACOUB:

"Magdi has changed our definition of what is possible."—Gordon Brown, Former UK Prime Minister

"The world’s leading cardiac surgeon"—The Sunday Times

"Renowned heart specialist Professor Sir Magdi Yacoub"—The Guardian

“Recognized as one of the great pioneers of heart transplant surgery”—BBC Radio

Book Description:


The incredible life story of legendary cardiac surgeon and scientist Magdi Yacoub, an outsider who succeeded against the odds
About the Author
Simon Pearson worked for The Times newspaper in London for more than thirty years. He is the author of three books, including the bestselling biography The Great Escaper. He currently writes obituaries for The Times and lives in London.

Fiona Gorman worked for The Times newspaper in London for more than thirty years. She has written on a range of subjects including mental health. She lives in London.

Dame Mary Archer is a British scientist specializing in solar power conversion. In 2012 she was appointed Dame Commander of the British Empire (DBE) for her services to the National Health Service.

SOURCE: Amazon

More... (From the Heart: A Pioneer in Science and Philanthropy - A Conversation With Sir Magdi Yacoub) #AUC #EGYPT


Wednesday, February 22, 2023

#reading: A Piece of My Mind

 A Piece of My Mind



 Sanctity
JAMA. 2023;329(7):537-538. doi:10.1001/jama.2022.24989

The minutiae of clinical work intrude upon me at all times. The ping of an email announces a new message asking for a prescription refill, an urgent appointment, a question to be answered. The anachronistic vestige of the medical profession beeps angrily at me when the hospital operator pages me to call the pathology laboratory because of a mislabeled specimen. The yellow bar on the electronic medical record flashes an inescapable reminder that I have results to follow up on. In the clinic room with a patient, I struggle to remain focused as my eyes drift to the clock that relentlessly ticks away and into the next patient’s appointment time.

The next email awaits. The next page awaits. The next patient awaits. I rush through my day, hurtling from one encounter to another, putting out one fire and jumping to the next, pivoting from distraction to distraction. My attention remains fragmented, and I do not approach the end of the day with a sigh of relief but rather with mounting dread for the notes I must finish, the orders I must sign, the care plans I must manage.

No one entered medicine to stare at screens daily, but that is the majority of what I do. The patient appointments that comprise my day generate far more screen time than patient-facing time. The joy of my work centers around the time I have with patients, but often, the frantic pace of clinical care precludes leisurely conversations and opportunities to understand what makes my patient a human instead of just a patient. Each additional minute sitting in front of a computer drains me, but each additional minute I spend with a patient beyond the time allocated means that I will have less time for the next patient, the next email, the next page. This imbalance between what nourishes me and what exhausts me makes me question my career choice on many days.

But there is one place where time and distraction do not exist, where I feel insulated from all the external forces that demand my attention: the operating room. The sanctity of the operating room, with its sterile white walls, harsh luminescent lights, and gleaming trays of metal instruments, permits me no distractions. My pager is turned off, my phone is silent, my email is ignored. Here, no one can reach me. Here, in this moment, I create a sacred compact with my patient: I am here, just for you.

That singular focus is unusual in a world overflowing with distractions that constantly erode the intimacy of our human connections. When was the last time someone truly saw you, heard you, touched you, without the reflection of a screen imposed in between you or a plethora of interruptions shattering your time together? In today’s fragmented world, that singular focus is a gift, both for me and for my patients. It harkens back to a time when my predecessors made house calls, cared for entire families, and thrived on the sense of connection and compassion that remain the foundation of medicine. It fulfills a need, both for me and for patients. It reawakens my compassion for patients and clinical care because compassion flows best for me without any distractions worrying the edges of my consciousness. It reawakens my compassion for myself; that I am the type of physician I want to be, that I abide by the excellence in which I was trained.

With nothing between us, I see patients for who they are: human, vulnerable, and often frightened. With nothing between us, the patient-physician relationship becomes sacred again. Day after day, my patients and I connect, clasp hands, and exchange reassurances. It is odd that in some ways, the deepest sense of connection I feel in clinical care is when my patients are asleep. But it is a sense of connection rooted in a complete sense of trust. Patients entrust their lives, their pain, their bodies to me. To carry that responsibility is an immense privilege, but it is also an immense burden. I bear the burden of human error, which haunts me the next time I step into the operating room.

I watch as their spontaneous breathing stops and an endotracheal tube becomes their lifeline. I watch as they are eased into a living death. I stand by their side as machines force air into their lungs, as the surgical team gently lifts and repositions arms and legs, as the nurse scrubs their bodies to prevent infection. I honor their faith in me as my scalpel slices tissue and fascia, seeking to extract the intruder in their bodies. My patients are silent, but their bodies speak to me. A scar snaking around the belly button warns that I may need to reconsider a traditional laparoscopic entry. A raised slash across the chest reminds me of the urgency of the task; removing ovaries to extinguish the supply of estrogen to an estrogen receptor positive for breast cancer. A faint line curved like a smile announces that children wait for her safe return, just as mine do for me.

Bodies morph into battlegrounds as I struggle with adhesions, excessive bleeding, and abnormal anatomy. I cannot give up even when I feel strained; I find a way to innovate and create solutions. An operation cannot be hurried along. I cannot set a reminder to complete a task at the patient’s next visit. In the operating room, the here and now demands immediate attention. I only exist in the present. Hours pass, and I do not notice hunger or thirst; the hallowed nature of my task supersedes the demands of my mortal body. I can only focus on the instruments and the patient, dredging forth from my mind an intense concentration that I thought long diminished by the relentless race of modern-day life. My hands cannot waver. Each cut, each stitch must be precisely placed, those bodies remind me, because underneath the drapes lies someone’s beloved.

With reverence, I mend what is broken. With relief, I tie down the last knot. For if patients’ bodies speak to me, so too do I speak to them: I care enough to do my best. I remain focused and alert until I set the instruments down, remove the drapes, and the patient takes that first postoperative gasp of breath. I call their families, a distant voice providing comfort and solace, that yes, the surgery went well; yes, their loved one will go home later today; yes, I’m pleased with the results. I forge new connections in that moment of closure. I slip out of the operating room when the patient awakens. The frigid air follows me in a cloud permeated with the smell of antiseptic solutions and the rusty tang of blood. That silent communion has ended; until next time.

Section Editor: Preeti Malani, MD, MSJ, Deputy Editor.
 source: JAMA, 2023

 

To shoot an Elephant!