One year ago, in December 2019, a new strain of a virus was discovered. The world would never be the same.

Is there anyone still here? It seems everyone has vanished. Nobody’s awake. The whole earth was of one language, and of one speech: a people united under horror, a people divided against themselves. A response so laughable, so unbelievably ruinous, that thousands of its witnesses will never testify to the passive destruction of their country. This is the world we live in: politicians safeguarding their agendas by annihilating populations, cities, nations. Ancillary genocide. Incompetence and malice.

Those who would have you believe that everything is under control. Those who would have you believe that there is nothing to worry about. They said, Go to, let us build us a city and a tower, whose top may reach unto heaven; and let us make our home in our Noah’s ark of excess and of peace. Press releases and public statements tranquilizing the public from taking any action, making them docile for the slaughtering. This is the world we live in: health is the right of the privileged. Floors of hospitals reserved for public officials while the poor die in the streets. Ventilators given out based on fame while doctors take their last breath for a country they shed their souls for. But what country? What country is there anymore? It’s a caricature. A nation divided is no better than agar.

Since everything is fine, fine enough that we can go to our educational institutions or our economic multipliers, why don’t we go outside? Tell me what you see. I see everyone drifting away. Never mind the tragicomedic lack of safeguarding measures, that’s not their fault. It’s the fault of those in that tower that would have them believe that everything is under control. Big Brother will protect you. It’s desolate outside. I can see a plague. Go a little farther and I can see rioting. A people so divided they are protesting during a deadly pandemic. For weeks. They don’t know any better. They can’t see when they have been blinded by this regime. But I can see all too well, and I see every hospital turned into an isolation ward, every week dozens more join this ghostly parade.

And they said one to another, Go to, let us make brick, and burn them throughly. And they had brick for stone, and slime had they for morter. That is what we are: the economic bricks of the tower of cadavers. Our utility goes only as far as their dockets. So while you’re out, because everything is fine, take a look around. Take a look around at your country, The country whose rulers decided to have a long, plentiful winter break while you go to your schools and your jobs and risk your very existence because they told you to. Even the statistics they release are laughable. Why don’t you go ask a real doctor how bad things really are? How many people they have to watch die on the streets? How many more bricks until the tower collapses?

Go on then. Have them send us to midterms, send us to our jobs, send us anywhere they want to send us because the only thing they have truly demonstrated is that there is no value to human life. There is no value to family. There is no value to unity. There is nothing in this world to believe in. Nothing except the tower.

They all speak the same tongue, that of deceit and corruption. And when their tower topples over itself, when its razed to the ground by the fire they pretended to put out, remember this: this is the world we built. You have proven that there is nothing alive more agonized than man of all that breathe and crawl across the earth.

4 Acts

Act 1

Doctor “culture” has always fascinated me.
I can only speak for Egyptian doctor culture, though I am sure overlaps will be found aplenty internationally. In Egypt, there is a notable proliferation of “doctor families;" that is, families where being a doctor is essentially passed down from one generation to another, and not being a doctor is more often than not seen as taboo and shameful.

The reason for this is easy to see: the myopic educational worship of medicine and, to a lesser extent, of engineering. Because college admission in Egypt is entirely based on your GPA and test scores, the fields with the highest cutoffs have become badges of honor for obsessive parents. And so, doctor families emerge.

By my account, there are two types of doctor families: the first, and more common one in my admittedly anecdotal experience, is the type that pushes their offspring to continue the tradition. They might even inherit the family clinic! They push them to get the highest scores in Thanaweyya Amma or the American system or IGCSE or whatever flavor of terrible “schooling" they can throw at them.

In the case where they fail to get into the more selective public medical schools, their parents must scurry to scrounge up enough money to send them to the less selective, very expensive private medical schools; of course, all of this is while maintaining to the outside world that they “just wanted to have a better, classier experience surrounded by classier people, of course they got into all the public schools," but that those public schools “are a waste of time now, didn’t you hear? So many commoners and falahin (peasants)."

In the the case where they do make it to the more selective public schools, their parents rejoice! The world is saved. They even buy them cars or whatever other worthless trinket keeps them happy. They go on to medical school and, notably often, are mentally scarred by it. Studies have shown very alarming depression rates. What about this one: 57.9% prevalence of depression among first year medical students in Alexandria . That’s not a round number, so here’s another one: 60% prevalence of depression among all medical students in Fayoum.

Med school professors will probably have you believe that these numbers are even closer to 100%, with many of my contacts directly saying “the whole class is on SSRIs (antidepressants)." It would make sense for these to be lower than reality, because mental illness and depression are very taboo topics in the Middle East.

I know medical school is hard. It’s one of the most challenging things you could ever hope to do in your life, academic or otherwise. It’s actually so challenging that many, many people try to use the wiles of nepotism to traverse it. If you’re the son or daughter of an Egyptian professor of medicine, you’ve heard this tango of a phone call a million times: “Hey, Dr. X, hope you’re doing well. How are the kids? I hope they’re great. You know, my boy actually has a test tomorrow in your class, so if you could just put in a word for him, that wou-"

And you know how that tango ends. In fact, this is so deeply ingrained into doctor culture now that no one actually thinks it’s wrong. At all. You know why? Because then you know that person has your back when your kid needs a word put in for them. If you even try to criticize this behavior for how corrupt it is, you are met with scornful chants of “they’re just kids! Don’t be so hard on them!"

Eventually both your kids (mentally scarred, incompetent beneficiaries of nepotism) become doctors!

So what happens when you combine incompetent doctors with a governmental infrastructure that entirely ignores, even maligns healthcare and healthcare workers?

Wait, add a deadly pandemic on top of that, too.

Death. Destruction. Innumerable losses. An exodus.

A complete collapse of civilization. All painted over with the now-omnipotent brush of authoritarianism.

There are three more sides to this story.

Act 2

In 2015, independent writer and journalist Khaled Mansour wrote an article constructively criticizing the injustice of the Egyptian healthcare system. The points he brings up are both obvious and valid: good healthcare is decisively inaccessible to most Egyptian citizens, and private healthcare is shamelessly corrupt. To remedy this, laws and policies have been drafted to push Egypt closer to universal health coverage (UHC).

Most notable is Article 18 of the new Constitution of 2014, which outlined the intentions of the state to build a comprehensive healthcare system, starting by doubling their investment in public healthcare from 1.5% to 3%, with that rate progressively rising to global averages. The article ends on a positive note, with Mansour telling the story of trade unionists affirming to each other that they will not acquiesce until the government does right by its promises.

“...acquiescence in such issues is tantamount to succumbing in silence to a preventable death."

Congratulations! You just graduated from Egyptian medical school. Years of suffering, yearning, depression and sleepless nights have all built up to this: your first paycheck at the university hospital: $120. Your expenditures for the month? $183. Hey, let’s say you become a professor of medicine, might take you a good decade or two, but you’re in too deep to stop now. Your paycheck? $600.

Egypt hates doctors. There is no other way to rationalize the data and the events that have transpired in the last 3 years, and even before. The actions of the Egyptian government against healthcare workers are nothing short of astounding. Let’s review.

As there is no law set in place to evaluate medical errors and malpractice, doctors are sometimes the subjects of unfair trials for “mistakes" they did not commit. Doctors in Egypt remain criminally underpaid, but they are even more criminally underappreciated. Of course, the global free market does its job sometimes, and there will always be demand elsewhere for great doctors. As such, there has been a mass exodus of competent doctors from Egypt to other countries, such as Kuwait, the UAE, Saudi Arabia, Sweden, the United Kingdom, and more. Access to physicians was already incredibly difficult, but now, it is getting close to physically impossible.

“If this continues, Egyptian patients will soon find nobody to treat them," Ehab el-Tahir, member of the Medical Syndicate Council, said.

In 2019, a new strain of a virus was discovered.

The world would never be the same.
Like many nations, Egypt was shaken to its very core by COVID. This virus has completely sliced through the thin layer of civilization that the establishment had been neatly sewing for the better part of a decade. Concerning healthcare, the negligence and heedlessness of the government when the Medical Syndicate repeatedly besought them for more protective equipment, wider access to testing, and better working conditions for healthcare workers so they could survive the pandemic, only ended up costing the government the lives of hundreds of doctors and thousands of patients.

But even those numbers are highly questionable. Questionable is not a word in the state’s vocabulary, however, as any form of questioning authority in Egypt is regarded as literal terrorism in the form of political dissent. Of course, this extends to COVID as well, where a Guardian reporter was told to leave the country by Egyptian officials for challenging the COVID statistics released by the government. Of course, it’s difficult to gauge the real death toll of the virus, but every doctor can attest to the fact that it is significantly worse than the nation reports.

For example, there was a very famous, and very harrowing video posted on Facebook of an individual walking through an ICU where, according to him, “everyone had died," citing an oxygen shortage as the reason for their deaths. Of course, the government immediately came up with a highly questionable narrative that conflicts with that of every witness at the scene, but because the government is also the investigating agency, it was all swept under the rug, the same way that that Guardian reporter was swept under the rug, the same way that hundreds of other investigative journalists were swept under the rug.

Reporting on anything in Egypt is essentially a crime now, plain and simple. In fact, stating facts of national urgency is also a crime now. Remember how the Medical Syndicate besought the government for more PPE, more testing, and less incompetence in general, citing the government’s negligence as a primary reason for the numerous deaths? About that, the prime minister responded by actually saying that it was the doctors’ faults, and that it was their negligence that was costing us lives.

Of course, all the pro-state outlets came out of the woodwork to paint doctors as literal terrorists. Did you guess that? Well, it’s a common tactic in Egypt. If the state doesn’t like someone, they find a way to associate them scurrilously with the Muslim Brotherhood, a terrorist organization universally condemned maligned by Egyptians.

Yes, during a pandemic, Egypt painted its doctors as terrorists because they said they needed more PPE and testing.

You would think that the nation would treat its heroes in blue a little bit more cordially during a pandemic, but Egypt defies rationality. In fact, Egypt defies nature itself! During quarantine, the number of COVID cases actually rose, but when the government decided to remove the quarantine, COVID cases hit an all-time low! I wonder if there was any tampering with the statistics there.

Of course, Egypt has had its fair share of tragicomedic occurrences during the pandemic, such as the Alexandria protests of the Coronavirus. Yes, they were protesting the virus itself.

Less comedic, more tragic, were the stories of Walid Yehia and Ramy Ismael. Dr. Yehia was one of the many people denied their constitutional right to healthcare, not being allowed a bed at a quarantine hospital. Similarly, Ismael’s mother was denied a bed at a quarantine hospital when she received a positive diagnosis after waiting weeks just to receive a test for the virus.

In contrast, when famous Egyptian actress Ragaa el-Gadawy tested positive, she was immediately admitted to a quarantine hospital on the recommendation of the minister of health. Dr. Yehia passed away, and there exists no followup I can find to Ismail’s story. The minister of health promised she would investigate Dr. Yehia’s case, and as with all of the Egyptian government’s promises, it has been swept under the rug.

Constitutional promises being swept under the rug. Sounds familiar, doesn’t it? Yes, the state promised us an overhauled, comprehensive healthcare system that would establish equity. The government still hasn’t fulfilled its promise of raising its investment in healthcare to global averages; in fact, it has failed so miserably at investing in healthcare that I can’t even access the article criticizing the budgetary priorities of the government without the help of my friends who don’t live in Egypt. Yes, Egypt blocks anti-government content. This is par for the course in an authoritarian society.

But technically, the government didn’t actually break its promise.

Article 18: Health care Every citizen is entitled to health and to comprehensive health care with quality criteria. The state guarantees to maintain and support public health facilities that provide health services to the people, and work on enhancing their efficiency and their fair geographical distribution. The state commits to allocate a percentage of government expenditure that is no less than 3% of Gross Domestic Product (GDP) to health. The percentage will gradually increase to reach global rates. -2014 Constitution.

Healthcare is a right of every citizen, and the State shall allocate to it a sufficient percentage of the GDP. -2019 Constitution

Yes, in 2019, the constitution was amended. The commitment was changed from a concrete 3% to a nebulous "sufficient." There is no follow-up or clarification on what sufficiency entails.

It is simply up to the state, a state that, in its unabashed hubris, proposed constitutional amendments that would see its chokehold over the country’s freedom of expression, even outside of healthcare, tighten further and further.

A state that, in its shameless arrogance, arrested and detained anyone who dared utter a word about their crimes against humanity.

A state that got away with it. A state that won. If you go outside in my city, you might find thousands of factory workers striking, gathering en masse, beseeching the president for help about their jobs getting displaced. You won’t find anyone wearing masks. You won’t find anyone practicing any form of social distancing. Don’t blame them. It’s not their fault. All they can do is what they have been taught, which is that the state has their back, and everything is under control. They watch the big mummy parade, they hire actors and actresses, they put on a show to make you forget their ancillary genocide. They hire the same actors to make pro-army movies and TV shows to indoctrinate the next generation of sheep.

As long as they sweep all the skeletons under the rug, keep the masses docile for the slaughtering, and silence all opposition, then there’s really nothing they can’t do.

When Khaled Mansour said that acquiescence in such issues is tantamount to succumbing in silence to a preventable death, he didn’t realize one thing.

In the eyes of the state, we are already dead.

There are two more sides to this story.

Act 3

The observant reader will remember that I noted two types of doctor families, but only detailed one of them. To understand the second type of doctor families, we need to talk about framing.

The psychological framing of medical school and being a doctor is an integral part of answering the question of why. Why do we want to become doctors? Why do we want to go to medical school? Medical school IS hard. Working in Egypt after graduating is even harder. You won’t make money. You’ll overwork yourself with 3-day shifts. You won’t be able to see your kids much at all if you, perhaps foolishly, decide to have any. So why do Egyptian kids still want to be doctors?

Because they’ve never asked themselves why. Because their parents, and their society and culture, have set up a psychological framework where it is the only viable option. They are conditioned with gifts and promises of cars, trinkets, and so-called “prestige" to think that medical school is the right thing to do for them. Because their parents did it. Because their grandparents also rewarded their parents with cars, trinkets, and so-called “prestige."

Because no one ever stopped to think about the patients. The vast majority of these medical students here never think about the lives they are handling, the mental sacrifices that have to be made to become a doctor. They don’t care. They were conditioned to think that being a doctor is just a badge of honor to wear in family gatherings. They ask their parents to talk to their professors to ease up on them, to put in a word for them so that they can pass easier. They’re just kids, right?

Those are the “kids" who will be treating your kids when they’re sick. Those are the “kids" who will be performing surgery on your loved ones. Those are the “kids" who will have to make life or death decisions day in and day out. Those are the “kids" who will watch countless people die and will have to learn how to live with it. These are the “kids" who will have to sacrifice their mental and physical well-being, and for what?

Which brings me to my mother. My mother had me at the same time she was studying for her doctorate. I have a very vivid memory, so I remember when she would be holding me in one arm and her textbooks in the other, weeping because she knew she couldn’t spend time taking care of me because she had to go to her doctorate exam in a few hours, weeping because I was weeping at the thought of being alone, weeping because sometimes you can’t win, weeping because sometimes you have to make sacrifices for your duty. This was her duty.

The same way it’s a drafted soldier’s duty to leave behind his children and fight for his country. There is no difference between those two situations. Absolutely none. My mother was fighting and struggling to become a doctor to make my country a better place to live in, but when soldiers do the exact same thing, they are hailed as heroes, martyrs, legends in Egyptian folklore. When doctors do it, when they put their lives on the line and expose themselves to death and violence on a daily basis, they are lazy, terrorists, guilty of committing treason. Whether or not you agree with the soldier or the doctor that sacrifices their personal life for the sake of their duty is irrelevant; the point is that they’re the same.

The difference is that no one tells you what you’re really signing up for when you decide to become a doctor. When you go to the army, you are told it will be hard. You are told it will be demanding. You are told it will break you. Guess what, medical school is harder. Medical school is more demanding. Medical school will break you more.

That’s the second type of doctor family: the type that tells you what you’d be signing up for. The type that shows you that medicine is a tough, traumatizing field, that you need an unbreakable mental fortitude just to stay sane. There is no psychological framing here. There is no reward or trinket or car or so-called prestige. This is trial by fire; these are people’s lives you are dealing with here. and for what? For what? Why do we do it? Why do you do it? Why do you still want to do it?

Ask yourself that. For once. Ask yourself why you want to become a doctor, because a good why will make you withstand any how.

To all of you who still want to go to medical school in Egypt, ask yourself why. The money, the status, the pride your family will take in you?

None of it will be worth it. None of it will be worth the pain, suffering, and death. None of it will be worth the abuse and hatred from the government and people alike.

Why do you want to be a doctor?

There is one last side to this story.

Act 4

I look around this country and I notice something strange: every other day or week, an awful disaster occurs. Let’s see...

What about when a fire in an Alexandria hospital killed 7 COVID patients?

What about months later, when another fire erupted in a Cairo hospital this time, also killing 7 COVID patients?

What about months later, when a train derailed and killed dozens of people in Sohag, while injuring almost 200 more?

What about weeks, if not days later, when a building in Gesr El-Suez collapsed, killing dozens then too?

What about a month later, just 3 days ago at the time of writing this, when a massive road accident killed 20 people in Assiut?

Those are just the ones I’ve heard of. Just the ones off the top of my head. You know what’s worse? No one really cares anymore.

We are so accustomed to this that we don’t even bat an eye. We never do. Of course, we are outraged on Facebook momentarily. But then we move on with our lives and watch our propaganda TV shows and all is well with the world. People’s lives are cheaper than ever before, and one of the least-appreciated but most important characteristics of a system of government with an underlying core of integrity is the realm of the mundane: safety codes. The government’s ability to side with the people when it comes to keeping them safe is a key indicator of the health of the society.

But neither the people nor the government care anymore. Blood means nothing to them. Lives mean nothing to them. Human empathy is lost on them. Apathy pervades every sliver of their being, a being so unbearably light as to not even exist anymore.

Egypt exists in a different dimension. A dimension where death reigns supreme, and life is a passing thought.

So, why do I want to be a doctor?

Because I won’t let them sweep those skeletons under the rug.

Because I won’t let them make the masses docile for the slaughtering.

Because I won’t let them silence the opposition.

Because I won’t let them indoctrinate more sheep into their death-machines.

Because I won’t let them bastardize medical schooling in my country anymore, I won’t let them shamelessly lie and cheat and steal and kill in plain sight anymore.

Because when you have a duty to your world to fight for it, you take that duty upon yourself and never look back.

Being a doctor is a perpetual reminder of the value of human life, that value that has been lost on our world.

Being a doctor is transcending the inevitability of death for just a moment longer, a moment filled with the empathy and fulfillment of an unbearably heavy existence.

Being a doctor is suffering the ignominy of failure, again and again and again and again, and having the courage to get up, wounded and disgraced, and fight again.

Being a doctor is about not acquiescing, not succumbing in silence to a preventable death.

Being a doctor is not going quietly into that good night, that slumber of apathy and ignorance.

It is to rage, rage against the dying of the light.