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Point of View

Seeking understanding
By Elizabeth Tucker Marshall, M.D.

Two days before September 11, 2001, my husband, daughters, and I sat dipping pita bread into a lamb and rice dish in the Al Tamimis' humble living room. We had been invited to join this Iraqi family of seven for dinner. After dinner, while six-year-old Emma and eight-year-old Berit cavorted with the Al Tamimi children, the adults quietly discussed everything from who Jesus is/was to the Palestinian-Israeli conflict. The peace-loving Al Tamimis, who were exiled from Iraq during the Gulf War because the men of the family opposed Saddam Hussein, alternately worked their rosary-like Islamic prayer beads and shared with us their experience with Islam.

My favorite patients are the elderly Iraqi women in loose, black, head-to-toe garb, their form lost within the folds of cloth.
Illustration: Suzanne DeJohn

The family has lived in the United States for eight years, the children speak fluent English, and several grandchildren have been born on U.S. soil—but in their home, bedouin customs prevail. A dining table sat empty in the next room as we sat cross-legged on the floor, eating with our fingers, a cloth laid down to serve as a table.

Backdrop: Through a satellite dish perched atop their house, Arabic television played a continuous backdrop to our meal: "Suicide soldiers," their faces darkened by black hoods and expressions of hatred, marched down dusty Palestinian streets, committed to dying for Jihad. We watched graphic footage of dead bodies and grieving families. Across the screen in bold Arabic letters the word "Satan" appeared, referring both to Israelis and to Americans who support Israel. "They think America is Satan," explained our friends matter-of-factly, neither apologetic for nor in agreement with the sentiment.

We returned home that evening unsettled by the depth of hatred that fundamentalist Islam fosters toward Americans—feelings contradicted by the curious, respectful, and prayerful people with whom we had shared dinner. Two days later, I watched the second World Trade Center tower collapse in real time on TV.

Immigrants: My undergraduate major was religion. I studied the history and religious practices of Islam during those liberal-arts years. Everett, Wash., where I settled after completing my medical education, is one of three areas in the U.S. that received a large number of Islamic Iraqi immigrants in the early 1990s. They stepped off the plane just as I hung up a shingle. I thus began a practice unusual in its mix, from the mayor's wife to these remarkable immigrants. The first infant I delivered here, in fact, was Iraqi. Baneen's tiny new reality was followed by many more squealing Islamic newborns, all blessed with prayers by their fathers within minutes of leaving my slippery hands. Baneen's sisters' simple weddings introduced me to Arabic dance—a glamorous and seductive secret every young woman hides under her mantle and produces, demurely, for her female peers. And it was on her parents' floor that my family and I sat just days before 9/11.

My favorite patients are the elderly Iraqi women, dressed in loose, black, head-to-toe garb. Their natural form is lost within the folds of cloth as they lean toward me on the examining table, their curved posture betraying hours spent in prayer on the floor. From them I receive Islamic blessings for a long and fruitful life for myself and my children. For these I am grateful, believing every prayer to be good. Sometimes my office feels like a cross between a therapist's couch, a mosque, and a clinic, as in one breath a patient utters a prayer and in the next starts to weep—mourning her loss of a homeland, the violence there, the prejudice here, and the pain in her osteoarthritic knee.

There is vast diversity within Islam. The Islam of the Taliban and the Mujahadeen, the oppression of women and the punishment of thievery with amputation, the declaration of holy wars and the toppling of the twin towers—these all belie the reality of Muslims who value the role of women, who work for peaceable solutions to conflict, and who respect "people of the book" (the book being the Bible and the people Jews, Christians, and Muslims alike). One does not negate the other, though both act in the name of God. So it has been throughout history.

Conflict: Recently, President Bush created a stir by answering in the affirmative when asked, "Do you think Christians and Muslims believe in the same God?" His response roused the ire of U.S. evangelists. How ironic that Muslims believe we worship the same deity, while some Christians preach a theology of division and conflict.

Guns are not the answer; education is. I am fortunate to have studied religion and to know many Muslims at a moment in history when the Islamic world is of such importance. Islam is the world's most rapidly growing faith and will soon be its largest. The future depends on our relations with this perplexing and potent global neighbor.

An elderly patient of mine traveled a while ago to Mecca to touch the kabbala. A sacred pilgrimage without which no Muslim is complete, it requires days of walking around this mystical stone, moving ever inward with thousands of others. Then one briefly touches the kabbala's cloth-covered surface and circles back out again. This patient returned with a gift for me—a pink plastic snow globe enclosing a tiny black replica of the kabbala. I was tempted to throw away the garish object. But since 9/11, it has sat on a shelf next to my bed—beside a crucifix, surrounded by the writings of saints and Christian thinkers. I leave it there to remind me to grapple with the contradictions in our world and to try to forgive—not only the Muslims who wrought destruction on 9/11, but also the Americans who presume to judge all Muslims without first seeking to understand.


"Point of View" provides a personal perspective on some issue in medicine. Marshall, a 1987 graduate of Dartmouth Medical School, is a family physician in Everett, Wash.

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