In the Land of Invisible Women (36 page)

In the weeks that followed, Reem quickly became formally engaged and began to return to Jeddah on weekends more often than her custom prior to engagement. There she would meet her fiancé in her family home, or sometimes his, always chaperoned. It was clear she would soon be a married woman but first she would begin her fellowship in Canada as an engaged woman. In the weeks leading up to her June departure, she asked me to be part of her farewell party, which some female surgeons were busy planning. There would be a soiree at her apartment on the compound. Recently returned from a few weeks out of the Kingdom myself, I was excited to attend and give Reem a proper send-off.

As I arrived at her apartment, I found myself in the middle of a scurrying throng of Saudi women. They were all dressed in pretty daytime ensembles, mostly long skirts and long-sleeved blouses. The air was thick with perfume and heavy with hair spray. Every woman was long-haired and none other than Reem and I were raven-haired. Most were dyed reddish in pretty shades that complemented their warm skin tones. The women laughed and giggled, occasionally leaning on chairs to ease a stitch caused by so much giggling. Most of the conversations were in Arabic, so I was left to watch the scene in puzzled silence.

Glasses were filled with sparkling apple juice, known widely in the Kingdom as “Saudi Champagne.” Reeme, a junior surgical resident and one of Reem's closest friends, was busy arranging fresh mint leaves inside long flutes readied for the sparkling juice. Another friend, Leila, a medicine intern, was scooping ice out of the ice maker, occasionally spilling cubes onto the marble floor.

Next to me I knew this was Mai, also a young surgeon. Though she had been at the National Guard only a year, she already had a well-earned reputation as a defiant wild child more at home in South Kensington than Saudi Arabia. She was already whipping up a storm of controversy with accounts of her antics in Europe the previous summer. She was fun.

I glanced at Reem. In the midst of this joyous party I noticed she looked overwhelmed and a little bit awkward at the sight of so much revelry in her name. She was uncomfortable with the genuine warmth that so many women surgeons and physicians at the hospital clearly held for her. We gathered our plates, filling them with delicacies, and settled in the sitting room, a sewing circle of Saudi surgeons.

Mai was laughing raucously about a quip she had just cracked. The others were in stitches.

Mai and I talked about how much we liked the gym where we both worked out, a welcome relief from the daily drudgery of Riyadh life. The al-Multaqa was always a glossy, cosseted, and very satisfying experience. A women-only venue, we could allow our abbayahs to fall away and move through the high, opaque-glass atriums and saunter toward aerobics classes or browse the Internet in a downstairs café or study the latest fashions imported from Paris and London. The architecture was airy and Scandinavian with a touch of Vegas about it.

Mostly we loved it because there was no need to veil inside where everyone, the cleaners, the waitresses, and the instructors were women. On this we agreed and as we discussed our weekly routine I realized why we had never really spoken inside the club. By the time I arrived, Mai was usually huffing and puffing as she did her crunches and reps on the StairMaster. Sometimes she stretched out her tired muscles on the yoga mats next to the ballet bar, eyeing herself critically in the floor-to-ceiling mirrors. Ruddy-faced, we usually nodded a brisk hello to each other before going our separate ways, she ending her workout as I began mine. I had no idea until today that she was a friend of Reem.

“So how did you like London, Mai? You were telling me…” I prompted her to continue, “You mentioned you lived in South Kensington?”

“Yes, Qanta, or ‘Saudi Kensington’ as I like to call it. London is fabulous. The restaurants, the shopping, the movies, the bookstores, it's all great except that, like Geneva or Marbella, half of Riyadh is there at the same time. Even London can get to be a bit suffocating.”

Mai paused while I tried to think of something diplomatic to say. She had a very staccato mode of communicating, leaving me forever unprepared for the ends of her sentences. We struggled to find a rhythm in our conversation.

“Did you have many Saudi friends there in London too?” I offered, already fearing the question was a weak attempt to paper-over awkward spaces in our conversation.

“A few, but mostly I hung out with the Barts crowd. Most of my friends are English. But I often ran into a circle of Saudi girls, more my older sister's age than mine.”

“What were they doing in London, apart from perhaps decompressing from the cabin fever of being in Riyadh year-round?” I added, hoping she would not be offended.

She rolled her eyes dramatically.

“I know!” Mai exclaimed, “Tell me about it! Riyadh drives me stir crazy, especially my hideous veil. I am not one of the new generation that has bought into this veiling craze. I am like my mother, a rebel.” She tossed her head back releasing a fabulous laugh, embracing her own defiance. I liked her; she was spunky.

“But to answer your question, Qanta, a lot of the Saudi women were in London having medical procedures performed during convenient short breaks.” I looked up peering at her closely. Mai wasn't joking.

“You mean plastic surgery surely. Let me guess: breast jobs? Rhinoplasties? Liposuction? Botox?”

“Yeah, yeah, Qanta, all of that, except we have some terrific surgeons in Riyadh now who do that right here and relatively less expensively than flying to London and staying at, say, the Dorchester. No, they go for something rather more exotic.”

“Well, what else, Mai? What's the rage right now in elective procedures?”

“Hymen reconstruction, of course, haven't you heard? It's the latest craze at the moment. Women from here are going over in droves for the awfully convenient repairs!” She looked around triumphantly, revealing a downwardly curved smile immediately betraying an insatiable appetite for attention seeking. I stared at her blankly. She explained.

“Qanta, in our society, a woman's honor is her virginity. It must be preserved at all costs and kept intact until marriage. There is simply no negotiation about this matter.” I nodded, aware this was true in my culture too. She continued, “In Saudi, of course, some girls are risk-takers, rule-breakers, like anywhere else. They perhaps are pursued by men who desire them, maybe they are caught up in their immediate desires. We are human after all. We are not perfect, we are not frigid, we feel!” She searched the sewing circle for a response. The crowd began to separate a little from us, safeguarding themselves from even talking about such a diabolical taboo. Mai was undeterred.

“So some girls, not only Saudis, but also from the other Gulf countries, are determined not to let a little matter like lost virginity land them into disaster. A woman whose virginity is lost could never be marriageable in our society, unless of course she is divorced and then everyone knows she is ‘used goods’ or a ‘hand-me-down.’ For the rest of us unmarrieds, it all depends on the contiguity of the hymen. In our society the anatomy of the hymen carries a medico-legal value, Qanta. This is a very serious matter.”

“So where do these women go? What is the procedure?” I asked, curious to know more.

“A lot of this is done on Harley Street and in the surrounding exclusive clinics in London. It's a minor matter, I hear, perhaps just a few days' recovery. Sometimes they can place tiny stitches and repair the defect; nowadays I think they can even fix it with a laser. Ouch.”
²⁹

I shifted, uncomfortable at imagining the procedure but more so at something imperceptibly vulgar in Mai's demeanor. As a physician, no subject was ever truly taboo, but something about her audacity and her insensitivity in such a cloistered community made me uneasy. I wondered exactly how she could know what she did and immediately pushed my uncharitable suspicions about her away.

Mai continued, relentless, “Other women need a more extensive reconstruction. They might need to be fitted with a biodegradable implant of a membrane that can simulate the whole thing… and our habibis can never know.” She descended into an orgasm of laughter.

I was astonished. In all my years of attending patients I had never read of hymenoplasty as a past surgical procedure. Over a decade of history-taking and I hadn't come across a patient who admitted to undergoing hymen repair. Staggering too was the value the Kingdom placed on virginity. For Saudi families, like most Muslim cultures, a woman's chastity was a family honor, a property to be prized. If she lost her chastity, her intactness, whether by choice or by assault, the family's honor became irreplaceable. This terrible burden on young women, some of whom were perhaps lost between two privileged cultures, or far worse, prey to predators, drove them to seek out solutions including the hymenoplasty that Mai described.

The rising number of these procedures being performed elsewhere in the Persian Gulf is well-documented and the subject of a number of reviews including publications in both
The Lancet
and the
British Medical Journal
. I knew Mai was not making this up; I had seen the articles myself. Quite sure that the procedure was illegal in the Kingdom, I didn't dare ask anyone about this, not even my closest medical colleagues. After Mai's very public allusion to the subject, I never heard it discussed again, but the data was clear. Women were desperate to present themselves as virgins in a climate where suspicion was cast even by family members, or perhaps especially by family members. I was well aware of the consequences—divorce, often—if on the wedding night a bride was found not to bleed after intercourse, raising suspicions that she was not pristine after all. A single word and her honor was dismantled forever, based on the unquestioned word of her husband.

Women were learning to retaliate, however, threatening to countercharge the man's sexual inexperience or worst of all denouncing him as impotent, the threat of which forced some men to continue their marriages in an uneasy truce of resentment and clouded suspicion. In other circumstances, women could risk death if determined not to be virgins. Honor killings are widely reported among Pakistani, Jordanian, and other Muslim communities, but I had heard nothing of this nature during my stay in the Kingdom. I had no doubt, however, that in tribal and closed communities, such a violation of the family's honor could well cost a young woman her life.

As a result, women who had means flew out of the Kingdom (presumably under the aegis of a male relative) to secure the skilled repair of the hymen as a preparation for marriage. Many are operated on in Egypt, while others opt for Mai's leafy and expensive stomping ground in West London. Data suggest the rising numbers of procedures in Egypt has significantly curtailed honor killings in that country, encouraging the surgeons that they are certainly relieving distress and extending life by performing the secret reconstructions. Some surgeons are able to repair the membrane and insert a viscous, red-colored gel that mimics blood flow after rupture, a procedure called hymenorraphy. This technique satisfies both partners by providing the sought after physical evidence that a virgin has been penetrated (even though this is not definitive medical confirmation of virginity). This procedure also protects actual virgin athletes, who may have bled without notice in their youth and are thus unable to provide the tell-tale stain on their wedding night.

My head was spinning from Mai's unwelcome assault of sexual practices in the Kingdom. I returned to the fray and joined the circle of women who were by now swaying with laughter. At the center, Reem actually looked to be holding court, thoroughly enjoying the proceedings. I returned to sit next to my friend in the middle of the sofa and I noticed Mai smirked uncomfortably to the outside edges of the gathering. For the first time I finally realized that she looked less at home even than I did. There was something barely tolerated about her. She was an outcast in her own community.

Disregarding my uncomfortable observations, I turned to Reem, “Translate for me! What is so funny that has you laughing hysterically? I want to know!” Reem waited until she caught her breath and then turned toward me.

“My goodness, Sameera is hysterical.” Reem pointed toward one of her guests who was obviously regaling a tale to the rest, tears streaming down her face with laughter. In the tumult of Arabic, I recognized a name I knew: Thunayan. He was the extremely tall surgeon whom I had seen from time to time in the ICU. A dour man, not at all attractive to me, I always thought him aloof; perhaps because of his extreme reserve, and especially so when compared to the alternative and friendly Mu'ayyad whom even I had to admit was incredibly sexy. What could they be talking about?

“She's talking about her attraction for Thunayan. Apparently he is not married yet. He just returned from Canada, Qanta.” Reem was simultaneously translating and giggling. “Well, Sameera has got a major crush on him. When she operates alongside him she says she can't remember the answers to any of his questions, so she feels like a fool, but she hopes her eyes look bigger as she glances at him over her mask.” Reem collapsed into more side-splitting laughter.

I looked at Sameera, who was flushed as she shared her innocent crush with the surrounding women, many of whom were still unmarried into their late twenties and early thirties. Like me, almost all of these women had selected career over and in place of marriage. Other than Qudsia, who seemed older, Reem would be the first among us to be married.