All Human Life and Loss in Palestine

The ‘Country Doctor’ is one of the most iconic figures in medicine. Kafka and Balzac wrote novels about him (most examples are male), and Chekov based many of his short stories on his experiences and insights as a country doctor.¹ John Berger wrote The Fortunate Man, with photographs by Jean Mohr, based on John Sassal, a GP in remote and rural Gloucestershire.² W Eugene Smith produced a famous photographic and text essay on a country doctor in Kremmling, Colorado, for Life magazine.³ John Bain and Rosie Donovan in Scotland,⁴ and Tom O’Dowd and Fionn McCann in Ireland,⁵ recorded many country doctors in photographs. There is a substantial literature of potboilers, doing for country doctors what James Herriot did for country vets in All Creatures Great & Small.

More than any other figure in medicine, country doctors exemplify what Trish Greenhalgh described as: ‘... the internalised, embodied knowledge that comes from years of listening to stories, building relationships, touching the flesh, responding to real or perceived crises, and witnessing the suffering, healing, coping and dying of ordinary folk’.⁶

Or as Julian Tudor Hart wrote of his patients: ‘From many direct and indirect contacts, many non-medical through shared activities, schools, shops and gossip, I have come to understand how ignorant I would be if I only knew them as a doctor seeing them when they were ill. It is a compact world, in which integrity and a sense of proportion are more easily retained than in cities, provided that one accepts the multiple faces one must wear in an intimate communal life. There is immense friendliness, much bravery and generosity, a good deal of petty meanness, treachery and servile cowardice — but never indifference.’ ⁷

The latest addition to this rich strand of medical literature comes from an unexpected source, Dr Hatim Kanaaneh, a Harvard-trained physician who returned to his home village of Arrabah in Galilee. Although over 500 Palestinian villages have been demolished, built on, or covered with pine forest since the creation of the State of Israel in 1948, Arrabah has survived, in the heart of northern Israel, situated west of Galilee, east of Haifa, north of Nazareth, and south of Lebanon.

About 20% of the population of Israel comprises ‘Israeli Arabs’ as they are officially called, but in the north of the country the figure is near to 50%. In the same way that Raja Shehadeh used a series of Palestinian Walks,⁸ to describe aspects of living under military occupation in the West Bank, Kanaaneh uses a series of presenting, or chief medical complaints in general practice to tell tales of Palestinian lives inside the State of Israel.

Drawing on stories of family, friends, neighbours, and patients, Kanaaneh describes Palestinian society, based largely on family, religion, and working the land. A major recurring theme is how people have adapted to the loss of land and people in 1948 and to the gradual but systematic loss of land since then. Although Kanaaneh returned to Arrabah in 1970, his stories and memories span a longer period, covering Ottoman, British, and now Israeli, rule. Much of the culture will be unfamiliar to western readers but Kanaaneh is a helpful guide, sprinkling the text with definitions and explanations of Arabic words, phrases, sayings and customs.

Kanaaneh’s previous book A Doctor in Galilee: The Life and Struggle of a Palestinian in Israel, recounted his frustrating experiences as the only Arab doctor working in Israel’s Ministry of Health.⁹ His new book is less angry and more pastoral, letting stories speak for themselves. All human life is here: pregnancies, weddings, and funerals; involving husbands and wives, daughters and sons, relatives and neighbours, at home, or in exile abroad. Conversation, coffee, and cuisine are the staple fare of ordinary life, with music and dance for special events. Many of the themes are familiar, involving the loss of the old ways, the scattering of families, improved health care, new ways of making a living, and so on, but the circumstances are extraordinary, having citizenship but not nationality, in a place where they have always lived. One of the subjects of the stories reflects: ‘Every Palestinian has a story worth telling. You scratch the surface and there is a treasure trove in every life.’

By drawing on a lifetime’s practice as a country doctor, Kanaaneh brings the story of his people to our attention.

• © British Journal of General Practice 2015