The title of Dr. Bakir’s erudite and engaging book brings to mind another book with a similar title. It is From Bagdad to Stambul (1892), one of the series of adventures that places its heroes in the city where Dr. Bakir was born almost exactly half a century later. The author of these stories was the once immensely popular German writer Karl May (1842-1912), whose books were translated into more than thirty languages and sold almost 200 million copies. Unlike Dr. Bakir, Karl May only read about the countries he described, at times while in prison for petty theft and minor larceny. Yet his stories about the American Wild West had generations of little boys crawling on the floor bedecked with feathers and reenacting the feats of the much loved Apache chieftain Winnetou.
By 1950 the little boys were already reading about space travel, and Iraq, as Dr. Bakir put it, “was on the threshold of becoming a modern country.” Invented as a new state in the days of the “Desert Queen” Gertrude Bell when the Western powers betrayed the Arab cause, it was the consolation prize given to Faisal, the eldest son of Sharif Hussein of Hejaz. He became king of Iraq, reigned well, and survived several Shiite insurrections. The storm did not break out until the Pan-Arabism of Gamal Abdul Nasser, when in 1958 a later monarch, Faisal II, and his prime minister Nuri Al-Sayeed were killed and had their mangled bodies dragged through the streets of Baghdad.
Dr. Bakir vividly describes the unpleasant days that followed, the dictatorships of General Qasim and of Colonel Arif; and the Baathist takeover and murderous rule. Then came the American interventions of 1991 and 2003, the massive destruction that followed, the Shiite holocaust, the draining of the Arab marshes and displacement of its population, the gassing of the Kurds, and the atrocities of the ISIS caliphate. Amid this historical backdrop, we learn that Dr. Bakir had grown up in a beautiful brick house with an open central courtyard and a tall date palm tree in its middle, with a well-appointed basement and a roof where people could sleep when the temperature rose to 130 degrees Fahrenheit.
In Baghdad, Dr. Bakir received a good education at a college established by American Boston Jesuits. He studied mathematics, biology, physics, and classical Arab literature, read about Gilgamesh, and had a wide exposure to British and American classics. When he went to medical school, one-third of the students were girls, and most wore the latest fashions; on the wards he saw schistosomiasis, malaria, amebiasis, giardiasis, hookworm, hydatic cysts, tuberculosis, typhoid, brucellosis, and cholera.
Drafted into the army during the Baathist regime, Dr. Bakir served in Kurdistan, where he saw many so-called tropical diseases, then augmented his experience with an internship at the Baghdad Medical College Hospital. In 1971 he made his “escape from fascism” and worked in hospitals in England, at Harold Wood in Essex and at the Millroad Maternity Hospital in Liverpool. He was impressed by the common-sense clinical approach of the British physicians, who always attempted to make a clinical diagnosis with as few ancillary tests as possible. In London he was beside himself with excitement when he saw the ancient artifacts in the Mesopotamian section of the British Museum.
Emigrating to America in 1972, Dr. Bakir arrived in Chicago in May to work at Cook County Hospital, then one of the largest hospitals in the United States. He describes being depressed by the “magnitude of poverty, severity of illness, near illiteracy, deprivation, uprootedness, rampant alcoholism, and drug addiction among patients.” Work was hard, facilities poor, and the ancillary tests were done mainly by the intern, who would admit as many as fourteen patients when on call. As years went by conditions improved markedly; Dr. Bakir eventually trained to become a renal specialist and spent almost thirty years as an attending physician at the County Hospital before retiring to private practice. In a series of informative chapters he describes his life in Chicago; what scholarly non-medical books he read; the city’s restaurants, museums, and intellectual life; his life as a renal specialist; and his travels to China and South Africa. In 1977 he briefly returned to his homeland, which had become one of the most oppressive states in the world.
Throughout the chapters on his medical life in Chicago, Dr. Bakir recounts his impression and interactions with some seventy-two professional people, mainly doctors but also his nurses. He concludes by discussing the problems of modern American medicine, the high costs, the near demise of personalized care, the strangling bureaucracy, and the expensive malpractice situation. To remedy these problems, rather like the situation in the Middle East, would require much wisdom and willingness to make changes and compromises.
For people interested in the Middle East, Dr. Bakir provides an engaging account of that troubled but fascinating region. What makes the book special is that it illumes its history from the perspective of an accomplished physician and sensitive man.
From Baghdad to Chicago, Memoir and Reflections of an Iraqi-American Physician, by Asad A. Bakir, Archway Publishing, Bloomington IN, 2018.
GEORGE DUNEA, MD, Editor-in-Chief