Chief Complaint: A Palestinian Doctor in the Galilee

Born in Arrabeh, north of Nazareth in the Galilee, Dr. Hatim Kanaaneh became the first Western-trained physician to serve his village. For several decades, he was the primary doctor for his village and its surrounding environs. During that time, he became an unceasing public health advocate for the Palestinian community in Israel recognized early on the state’s disregard for its Palestinian citizens, a recognition made all the more stark when he witnessed the public services provided to nearby Jewish communities.

Chief_Complaint_nonfinal__51468.1420580262.450.800In his retirement, he set out to tell the world about the Palestinian citizens within Israel, perhaps the least written about Palestinian community. Seeking to relate those experiences, he has authored a collection of short stories. Chief Complaint: A Country Doctor’s Tales of Life in Galilee, published by Just World Books, is an extraordinary collection of short stories about a Palestinian community that once had been simultaneously subdued by Israel (martial law was imposed until 1966) and shunned by the Arab world and still is marginalized by both Palestinian political factions in the Occupied Territories and Israeli society. And, yet, in recent years the community has risen to become the leading voice of Palestinian culture, an inspiring model for Palestinian unity (as exemplified in the Joint List, a coalition of Arab parties in the Knesset), and might be the bridge toward reconciliation and a shared future between the Arabs and Jews in historic Palestine.

The Institute for Palestine Studies recent sat down with Dr. Kanaaneh to discuss his upcoming book and the Palestinian community inside Israel, roughly 20% of Israel’s population. 

For many years you were a doctor and now you’re a fiction writer. First of all, how does a Palestinian kid arrive at Harvard Medical School?

Well, that’s true that I am the first Western-trained physician from my village in the Galilee, Arrabeh. And the first person from the village to go abroad and study. The decision to study medicine was really made for me by my family. As I was attending elementary school, I was a good student and everyone kept saying “you’re a good student, you’re going to be a doctor.” And so I believe them.

After I finished high school there was a great shortage of teachers for Palestinians in Israel. And anyone who finished high school and passed his exams could become a teacher and so I became a teacher for two years. It was then that I met a couple from Pennsylvania who were on a tour in Nazareth and I started corresponding with them. And they agreed to sponsor me to study in the United States and there was a very good scholarship offer from Yankton College in South Dakota. I did two years toward my B.A. there, but it got too cold and so I left and went to Hawaii. I finished my B.A. in Chemistry at the University of Hawaii, where I met my wife. And then I finished medical school at Harvard.

After that it was very attractive to think about sticking around the United States, and I had very lucrative offers financially, but then I would have lost the purpose in my life if I had stuck around and became an American physician. And so I went back to the village and tried to help as much as I could. It was very demanding. I was the only physician for miles and miles and had about 50,000 people who relied on me as their medical provider.

And I started working as a public health employee of the Israeli Ministry of Health and in that role I was in charge of public health services for most of the Galilee at that time, both Jewish and Palestinian communities. And I tried to really make a difference that way. And I quickly reached the conclusion that from within the system I’m not going to be able to change much.

What did you seek to change?

There was neglect in the health services and also the environmental services, such as provisions of running water and sewage disposal was never really handled by the responsible authorities, for the Palestinian community. There was a real black and white difference between Jewish communities and Arab villages. All Jewish communities had sewage disposal systems and all Arab villages in Galilee had no sewages disposal systems and you had sewage running in the streets as children were going to school. And that was really bothersome for someone trained in public health and who was providing health care to children [who were suffering] from diarrhea and vomiting. It was a major concern for someone like me who was providing health care for these children. I was trying to get to the base of this and provide decent environmental services and no one [in the ministry] was [interested] in hearing me.

So I joined three other physicians and we established The Galilee Society [to provide]  health services, for which I worked for fifteen years as the director and I’m still a member. So that was the second shot at attempting to make a significant difference.

And I imagine that the third shot is your fiction writing?

When I retired in 2005, I still had that urge to try to make a difference. And I like writing, that’s something, I guess, in my veins. I get up every morning and I do some writing. And I thought that the most significant contribution I can make to my community is to tell the world about it, because clearly Israel had prevented our issues from reaching the attention of the world at large. I saw [writing] as an opportunity to contribute to the welfare of my community, to even make it known [that] we exist.

So I wrote a book of memoirs about my struggle to provide health care and improve the public health of my community. That book came out in 2008 and it’s called A Doctor in Galilee. And that book didn’t really make a splash. It got a lot of positive reviews but mainly from Palestinians and their sympathizers.

And so I started thinking about that and it occurred to me that “you’ll reach a wider public” if I wrote fiction. And so that’s when I started collecting stories in my villages through the contact I had had with my patients in my clinic. I started collecting some of the events that occurred to my patients. And the outcome of that was this book Chief Complaint.

Looking at the titles of the short stories: High Fever, Chills, Headache, Neck Swelling, Chest Pain, Abdominal Pain, Insomnia, Back Pain, et cetera. . . How has the medical profession structured your writing?

A good friend of mine read my first book and made the comment that my writing reminded him of the writings of Primo Levi. And I didn’t even know who Prime Levi was and so I went and bought a book by Primo Levi called The Periodic Table. And if a chemist can use the periodic table to narrate the issues of his community and his memoirs, of World War II and the Holocaust, I think I can use the term ‘chief complaint’ to narrate about my community and my patients.

Chief complaint is derived from the first line of the classic physician’s charter, meaning: what brings the patient to see the doctor? And those are the titles of the stories and it goes by body systems. Starting with the head, neck, abdomen, leg and so on.

Did you have any prior experience with fiction writing or was this a whole new endeavor?

Well, in fact, this is something that I practiced since I was in high school. Whenever I had something that was bothering me I would sit down and write about it to get it off my mind. And so when I decided to write fiction I did two things. First, I started recalling incidents that had happened to me at my clinical practice. And the other thing, I spent one year at the City University of New York, at the Graduate Center’s Writers Institute. By the end of that year, I came to know a little bit about the proper way of writing fiction in the United States [It is much more structured and chronological]. But that’s not how we tell stories back home. So I got the confidence that when I broke the [American] rules I knew I was breaking the rules. If you take the limitations the craft of fiction writing puts on stories, you really lose all of the charm and the wonder of The Arabian Nights and the writings of such well-known Palestinian writers, like Ghassan Kanafani and Emile Habibi. So I decided to stick with the way we do story telling in the Arabic or Middle Eastern style of writing.

In Chief Complaint, each story and central character encapsulates several people in my village. It is a composite character for each story, made up of four or five, sometimes ten, people that I cared for in my village.

You’ve mentioned Kanafani and Habibi, two extraordinary writers who’ve had a huge impact on Palestinian writers and poets, what about other influences?

Well, you just mentioned those two, of course. I did read and sort of consciously at some level imitate Primo Levi. But I’m not all that widely read myself in terms of literature because I spent my life reading medical texts. So in that sense I reverted mainly to those Middle Eastern luminaries. In some ways I’m really inspired by two very well-known Palestinian poets. Of course, Mahmoud Darwish. There’s no Palestinian who’s not inspired by him. And the other is less well-known in the West, Taha Muhammad Ali, and he’s really my favorite. He has such a down-to-earth style about him. And although I don’t write poetry, I’m inspired in my thoughts and purpose of writing by his style of writing.

Dr. Kanaaneh at IPS’ Washington, D.C. office.

You’re a Palestinian citizen of Israel, of course. For readers unfamiliar with the community’s history, can you tell us a little bit about the history of the Palestinians in Israel? 

For many years after 1948, after the Nakba, we found ourselves essentially on the wrong side of the border. Like a friend of mine says, 85% of the Palestinians in what became Israel crossed the border to become refugees in neighboring countries, the rest – that’s us – we were crossed by a vicious border. And after that for years the Arab citizens of Arab countries around us looked at us suspiciously and considered us to be lackeys of the enemies. And that was a heavy load to shake off from our shoulders. And it is thanks to the literary figures who really played a major role in changing our image in the eyes of fellow Arabs in the Middle East. [Darwish, Muhammad Ali, Habibi, among others, are Palestinian citizens of Israel often referred to as ’48 Palestinians.]

Our isolation began to erode in 1967 after Israel’s occupation of the West Bank, Gaza and East Jerusalem. We became sort of advisors to the Palestinians in the occupied territories of 1967 because we had a longer experience with the Israeli system. In fact, from 1948 to 1966 we were under military rule, a very, very harsh system of control. And the control was through controlling movement and controlling the [employment prospects] of members of our community. The system of military occupation moved in 1967 to the occupied territories. It was lifted from the Palestinians within Israel and it transferred to the territories. Actually the same system and the same employees were taken and employed in the newly occupied territories. And so with that we could advise the Palestinians about the way Israel treats us and treats Palestinians in general.

As a citizen of Israel do you recognize any privilege that you may have in relation to other Palestinians?

The basic concept I rely on is that since the day Israel was established I was a citizen of Israel and I pay taxes to Israel. And as a public health physician who aspires to improve his community I refuse to accept any other standard of reference to which I compare my community other than the best among my co-citizens in Israel. There’s no way you’re going to tell me that I’m better off than the refugees in Lebanon because that’s a totally difference situation. I aspire to have my community’s health become at the same level as the best in Israel. However if you look at our health statistics, we function at much lower level than the rest of the Israeli public, the Jewish public. If you take the infant mortality rates of the Palestinian community in Israel, it has run 2:1 since the 1950s in comparison to the Jewish community. Our infants die twice as often as those of the Jewish community. And that really tells the story of how disadvantaged we are compared to the rest of the community in Israel.

Our communities are really bedroom communities. [Our men] go and work in [Israeli cities], say in construction, and return to sleep at night in the villages and not much beyond that.

As a doctor you were central to your village and much of the Galilee, has being a writer opened up a new community to you?

Well, Palestinians in Israel, we’re only a million and a half. So we kind of know one another.

What has really renewed the connection, at least for me, with quite a few other Palestinian intellectuals and activists is the new vision after the death of the two-state solution that has been bandied around for so many years. Among Palestinian intellectuals and activist and among some good number of Israeli leftist activists as well, there’s now a very widely accepted alternative to that: it speaks of one-state west of the Jordan river for all those who live there on equal grounds. It has multiple other layers – the return of refugees or the refugees getting their rightful rights – but the essence is a vision of a united democratic and secular state, both Jewish and Palestinian. And that vision has brought me, personally, in contact with quite a few other Palestinian activists.

I’m very proud of that and I’m very hopeful, especially since there is an equivalent number of Jewish intellectuals and activists who subscribe to that vision.

In writing Chief Complaint, which audience do you want to reach the most?

Well, I write in English. So the average English reader, American public especially, because in a way when we speak about those dreams for one-state for everyone west of the Jordan river, we are speaking about a vision that is not going to be actualized if the American political system, and the European system, does not stand behind it. So I’m not trying to reach the Palestinian or Arab public, although they are more than welcome to read it once it’s translated, but I’m trying to impact the public opinion in the West and especially in America. 

One final question, in writing these short stories, what was the most meaningful part of the experience?

Well, obviously, in writing these stories there was a lot of nostalgia and recollections of the harder days when I was working two full time jobs essential as the public health physician for the area, the Galilee, and the general practitioner caring for 50,000 people at one time.

So at the personal level there’s a warming sensation, “Okay, I did serve at some level,” there’s that rewarding kind of thing of patting oneself on the back and saying, “You did alright.” 

But, more seriously, there’s the realization after having accomplished this collection of short stories that I am aspiring to influence the public opinion in the United States. Why? I’m just a little village boy at some level. There’s a bit of megalomania in my background, which I don’t dismiss. I actually like being a bit of a megalomaniac trying to address the world-at-large from a platform of a little village in Galilee.

Beyond that, I’m not really out to establish a career. I’m at the end of my career altogether. It is very rewarding and very heartwarming to see how the public receives [the stories], and to receive me as a spokesperson for the Palestinian community within Israel. And at that level I’m very, very proud at being able to achieve that.

Excerpt of Chief Complaint:

In the spring of 1949, ‘Ammi Ibrahim turned overnight into a local hero of the Battouf area for reasons that had nothing to do with his acquired communist leanings or with his standing up to the military rule and enduring in his old age whatever that cruel system could dish out. It was his familiarity with the Battouf that bestowed on him a near divine mantle of knowledge and justice. That winter, Kibbutz Solilim brought in a number of tank-like weaponized tractors, plowed the western part of the valley as a single unit, and planted it with wheat. Everyone feared that that was the end: they were losing their ancestral land and livelihood. While people in all the villages wept in bewilderment and despair, ‘Ammi Ibrahim accompanied his nephew, the village mukhtar, on a trip to Nazareth to consult with Mr. Wonderman, an old Jewish acquaintance of yesteryears who was now entrusted with the job of Nazareth’s Chief of Police; the famous Mascubiyya, the Muscovite compound, was now his headquarters. He remembered the two guests well: they had once retrieved a number of cattle for him from the Bedouin marauders who had stolen them from his kibbutz not far from Tiberius.

He ordered a cup of traditional Arabic coffee for each of them. It was brought in by the cleaning woman at his office, no other than the daughter of an old friend of theirs from ‘Aylabun and the sister of two of the 14 young men killed in ‘Aylabun’s massacre less than a year before. Knowing that he was familiar with local Palestinian traditions, they expressed their wish for him to hear them first, for if he denied them the help and advice that they sought from him, they would not honor him with partaking of his coffee. He listened patiently to their tale of woe. He took a long time sitting across from his old Arab friends with his face cupped mysteriously and sympathetically, they thought, in his hands as he leaned over his desk. Then he said only one sentence, an old Arabic phrase that he thought was fitting for the situation: “Kul maf‘ulin jayiz.” All actions were permitted. They sipped their coffee, thanked him, and left.

Back in Arrabeh, they gathered all the elders of the various families and informed them of their decision to pick up the gauntlet flung to them by Mr. Wonderman. Each farmer was to go down and plow over the wheat that had already sprouted on his land and to sow a different crop—anything but wheat. The message was conveyed to all the other villages around. That was when ‘Ammi Ibrahim faced the most challenging task of his long life: he had to divide that part of the Battouf all over again. The intruders had removed all the simple stone markers by which farmers delineated their plots. He had first to decide where Arrabeh’s land ended and Sakhnin’s started. Then he had to decide where the Kanaanehs’ fields were located relative to the Yasins’. Then, within each clan’s area, he needed to separate specific plots of individual farmers. And so on ad infinitum. He had a lot of help, and much interference as well, from all of his fellow farmers. Each knew the approximate location of his plot and who his immediate neighbors were. That was helpful in arranging the plots relative to each other in my uncle’s mind. Inevitably, some villagers were disgruntled by what struck them as an arbitrary decision. But they all respected the man and, despite his single-minded obstinacy, no one ever suspected his motives or integrity. (The most difficult counterclaim to disprove was one put forth by a simple farmer who had ridden his donkey down to his land in the dark, and the donkey stopped at a plot assigned to a neighbor. Farmers had always relied on their donkeys to identify their land in the dark of night when one plot looked exactly like the other.)

Purchase Chief Complaint at Just World Books.

Follow Dr. Kanaaneh at his blog , A Doctor in Galilee.

Photo Credits: UK Task Force (banner). Just World Books (book cover).

By Khelil Bouarrouj.

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