“I have a broken toe, not a broken spirit” (Samantha, Sex & the City)

“Shit!!  Shit!!  Shit”!! I dropped to the floor clutching my right foot.  My partner, David, looked alarmed so I reassured him, “Nothing to worry about, just stubbed my friggin’ toe!  Shit!  Shit!  I’ll be fine in a sec.  Shit”!

We were in Luxor, Egypt and had risen to the sound of the wake-up call on our Nile Cruiser; today was our Valley of the Kings tour.  Needing bottled water to brush my teeth, I’d crossed the room to fetch it.  As I did so, I’d stubbed my little toe on the base of the bed.

My swearing subsided and I released the tight grasp on my foot to view the damage.  I expected a chipped toenail.  Instead, my toe was snapped to the side at a right angle.

David:  It’s broken.

Me:  It’ll be fine, I’m sure I’ll be able to walk.

I couldn’t.

David: We’ll get a doctor to the boat to strap it together.

After asking the boat manager to summon a doctor, David went to the restaurant and collected some pastries and juice for my breakfast.  I lay happily munching on the bed until a knock on our cabin door.  They were ready to take me to hospital.  Alarmed, I looked at David.  Wasn’t a doctor coming to the boat?  David shrugged, “They’ll just strap it together, we’ll be back soon enough.”

I hopped down to reception.  “Don’t take her to the local hospital, take her to the City International Hospital” our tour guide told the boat staff.  Good – that’ll be a decent standard.  With two crew helping me, I hopped out of the boat, across the boat moored next to it, up about thirty steps and into a cab (a severely beaten-up old car).

Along with one of the cabin crew, we quietly wove our way through the streets of Luxor.  Around us were dusty slums full of unfinished homes.  A few men dressed in light brown kaftans languidly wandered the streets and we passed some boys kicking around a football.  Otherwise it was deserted.  Egypt rapidly loses its gloss when you’re out of the tourist quarters.

We pulled up at large metal gates, guarded by men with guns, and entered the grounds of City International Hospital.  The fresh paint and modern appearance of the pink building was reassuring.

Five hospital staff in the large reception area stared as if they hadn’t seen a patient for a decade.  It was eerily quiet; there were no other patients or westerners visible and no one spoke English. The cabin crewman muttered some words in Arabic to one of the hospital staff and they fetched a shabby wheelchair and gestured for me to sit in it.  My feet rested awkwardly on a line of string where footrests should have been.  After forty minutes a man arrived and stood in front of me.

Him: Your foot?

Me: Yes, it’s my toe.  I hit it.

He cast his eyes down at my leg and said nothing.  In silence I was wheeled along corridor after corridor.  I didn’t see another female or patient.

Swabs coated with blood littered the floor of the X-ray room.  David spoke to the man from the boat, “Hi I’m David, what’s your name?”  The man looked blankly for a second and then spoke rapidly in Arabic (this was our chaperone and translator …).  In Tarzan/Jane style David pointed to himself and said, “David” and then held his hand out as if to say “and you are?”  The man laughed in understanding and smiled, “Abdul!  Abdul!”

After my foot was X-rayed, my wheelchair journey resumed; click, click, click.  The rattling chair was the only sound as I moved through endless corridors, turning right and left at various stages until I was lost in the labyrinthine building.  In each corridor a large clock hung from the centre of the ceiling and every one of them was stuck at twelve:  The Twilight Zone.

We occasionally passed one or two men in dull coloured kaftans, standing still and quiet, smoking.  They looked me up and down, leering and letting their eyes linger.  My outfit wasn’t revealing – a blue and white knee-length skirt and a blue sleeveless top.  I kept my eyes averted.

We arrived at a room and were greeted by a doctor.  I was directed to lie on the table behind a screen while the two hospital staff, doctor, Abdul and David looked at the X-ray of my foot.

Me: Is it okay?

David: Ah, no.  It’s dislocated and fractured.

Me: So what has to be done?

The doctor had limited English, but eventually we understood that they would try to relocate my toe.  David stood next to me while the hospital staff held me down, the doctor grabbed my toe and snapped it sideways.

“Aahhhh!!!!” Fucking!!  Fuck!!  I looked at David and burst into tears.

It was my anxiety, more than the physical pain, which was upsetting:  Why had this become such a big deal? I had only stubbed my toe.

Through broken English, we deciphered that the doctor had decided to operate.  This couldn’t be done under local anaesthetic, though it was unclear why.  I would need a general anaesthetic.

Me:  How long will it take?

Doctor:  Just ten minutes.  Put in place.  Fix.

Fine.  I would be back in our cabin on the boat that afternoon.  Let’s get it over and done with.

David was taken to deal with administrative issues like giving them my passport.  I was left alone with the doctor who sat next to me and started touching my hair and stroking my face.

Him:  You very beautiful, you married?

Me (smiling – he made my skin crawl but I was in a vulnerable situation and didn’t want to antagonise him):  No.

Him (smiling): You have children?

Me: No.

Him: Why?

Me: I don’t want them (he looked confused so I added something he’d understand). They too much money.

Him: Hmm, but I think David, he have enough money for children.

I remained silent while he continued to play with my hair and touch my face – my heart pounded. He conveniently went back to his seat a minute before David returned.  I was taken for a pre-operative check, my top and bra were removed and little sticky dots put on my chest to check my heart.  Was it necessary for Abdul and five hospital staff to be present for this?

I was wheeled to my sparsely decorated ward; a bed with no linen, a sofa for guests and a bedside table with a phone.  My operation would be in “a few” hours.  There was no clock in the room and all the clocks in the corridor were fixed on twelve.  Without mobile phones or watches, we waited not knowing the time.  Abdul sat silently on the sofa.

About four hours later, the only female I saw at the hospital came in, dressed in traditional Muslim clothing.  She gave me a green operating gown and instructed me to change.

Her:  Take off all.

Me (thinking it unnecessary to remove everything, I clarified):  All?

Her (a knowing look of sympathy crossing her face): Yes, all.

I left my underwear on – there was something sinister about this place and I didn’t want to expose myself any more than I must, or already had.  David did my gown up tightly and left to phone our travel insurer.

A man collected me and again I was wheeled down corridor after corridor.  Click, click – the only sound as I passed the smirking, leering men.  We turned into a dark, smelly room.  I thought for a resigned moment that I was here to be sexually assaulted.  But the man clicked the light switch on and I glimpsed mops and buckets leaning against a wall.  My rattling wheelchair was pushed through this room and into the next … the operating theatre.

An exclamation of hysterical laughter came out of my mouth.  I couldn’t believe I was to be operated on in here.  In this large beige coloured room (maybe it was white but covered in dust!) my eyes were drawn to the operating table and the machinery surrounding it.  The equipment was menacing; large, old and rickety.  There was no form of modern technology.  Not wanting to dwell on the tools that would be used for my impending operation, I looked down – only to see the dirty, peeling linoleum on the floor.

I hoisted myself onto the operating table.  No one spoke until a very elderly man wandered in and introduced himself as the anaesthetist.  He stood to the left of me and picked up my right hand which was lying across my body.

Anaesthetist:  Which finger?

Me (sitting up in alarm and pointing to my right foot):  It’s my toe!

He wearily glanced at my foot and walked around to my right side without saying anything.  He pulled my right arm and stuck the needle in the back of my hand.  I looked at the (working) clock on the wall with longing – I was looking forward to being unconscious.

Me: When will I pass out?

Anaesthetist (laughing): Oh not for while yet.  We still get ready.

I stared at the ceiling; it couldn’t be too much longer.

Anaesthetist: Okay now it is.

Me (almost excited with relief):  Oh yeah, it’s coming, it’s coming.  It’s definitely coming.

___________________________________________________________________________________________________

TWO HOURS & FORTY-FIVE MINUTES LATER

“Simone, Simone”, a strong accent repeated.  On my left, someone roughly fondled my breast.  On my right, I felt a hand pass over my knickers and then fumble its way underneath from the side.  The hand was over my private parts and trying to get into me.  I managed to mumble a semi-grunt.  Both hands withdrew at the sound of my consciousness.

Back in my ward, I told David what had happened and he checked my gown.  It had been undone.  Why was it necessary to undo my gown for an operation on my toe?  What happened during these two and three-quarter hours?  David had signed consent for an additional surgeon (a consent form written in Arabic …) but the rest was a mystery.

David argued with the hospital’s finance officer while I slept.  Before releasing me, the hospital wanted a guarantee from our insurer that they would be paid.

From a payphone on the dusty street in the Luxor slums, David established that our insurer had sent the required fax, guaranteeing payment, numerous times.  However the hospital fax machine was out of service; the hospital’s finance officer was absent during daylight (it was Ramadan) and hadn’t arranged for the machine to be fixed.  My passport was being withheld until this fax was received.  The logic was maddening.

I was wheeled out for another X-ray.  Out of David’s eyesight, the man pushing my chair suggestively stroked the back of my neck – as all the staff had.  I continued to ignore the insidious sleaze I’d experienced since my arrival.

The X-ray table was covered with fresh blood.

Me: I’m not getting on there (I pointed to the table).

One of the men:  Okay, okay.

He spat on a cloth, wiped the table and smiled proudly at me.  Sigh. There was no point in further protesting so I scrambled onto the table.  Afterwards I was wheeled into the smoke-filled corridor where men continued to leer.  I’d not seen a female since the young girl had given me my green gown.

Back in my ward I awaited the results of my X-ray, expecting to be cleared to leave.  Instead I was informed that the operation had been unsuccessful and I was given a choice; another operation in City International Hospital tomorrow or a second operation back in England.

“Okay, I’m going back to the boat”!  My foot could be sorted out back home, I just had to leave.

The phone next to me rang.

Man: Hello, it’s Hassan the boat manager.  When are you coming back?

Me: We’re trying to get out now, but I’m not sure what’s going on.

Hassan: Okay, I’m coming.  I’ll be there in fifteen minutes. (He sounded like a man who meant business! Rescue me, Hassan, rescue me!)

He arrived quickly, entering with a loud and inspiring, “Hello!  Let’s get you out of here!”  David and I laughed.  We were saved and, after fifteen hours, this ordeal was coming to a close.  Sitting down and holding a pen and paper, Hassan asked seriously, “Okay, what happened?”

I recounted how I’d received the injury while he wrote my statement in Arabic.  “Is there anything else you would like to add?”  Hesitantly I told him about my molestation incident.  Embarrassed, he cringed and apologised, giving the impression that it wasn’t remotely surprising or uncommon.  He asked if I wished to go to the police and I declined; the ogling by Egyptian police verged on sneering, and my experience of City International Hospital was enough to tell me that an investigation would be an unpleasant waste of time.

Determined to resolve the situation, Hassan distracted the reception security guard while “stealing” back my passport from his desk drawer and we “did a runner” to his car (difficult in a wheelchair ….).  As we drove back through the unsettling streets of Luxor, he turned and said one single, poignant word, “Freedom”.  We laughed with relief, “Yep.  Freedom”.

At the wharf I scrambled into the wheelchair, then stared at the thirty stairs down to the boat.  Shit.  But immediately my chair was hoisted by four of the fifteen cabin crew who were surrounding me.  Hmm…  They manoeuvred me awkwardly down the steps and across the boat moored next to ours.  When we reached the plank that connected the two boats they hesitated.  This plank was not much thicker than plywood.

Me (yelping urgently): I’ll hop across it myself! (Our combined weight would snap the plank).

All the men (insistently): “No!  No!”

We argued, but they simply wouldn’t let me go.

As they carried me onto the plank my back was lying parallel to the ground in the wheelchair.  If they dropped me or the plank broke I was likely to break my neck.  The plank bent alarmingly, then started to creak.  Jesus Christ!  I lunged for the boat – and made it on board.  Everyone cheered!

We thought it was all over, but problems continued.  At 2am the hospital’s finance officer arrived, demanding payment or my passport.  We refused and the next day we left the boat for a hotel room.  Lifting me up the steps was harder than lifting me down.  We abandoned the chair and the cabin crew held me around the waist.  By the time I reached the last step my skirt was around my waist and my knickers were exposed for all of Luxor.  Dignity was no longer a concern.

Nurses at the hotel gave me injections for the pain, though with no antiseptic, “cologne” was used to wipe the needles clean.  The hygiene throughout this saga was worrying – an HIV test was a high priority when I returned to England.

Mysteriously, the finance officer tracked us down, turning up at our hotel at 10pm to demand the insurance excess.  Reluctantly we gave it.  Now my only obstacle was leaving the country.

A “fit to fly” certificate was required for my two flights (tricky, as I’d left the hospital illegally).  Taking a chance, I turned up at the airport regardless, figuring that Egypt didn’t seem big on abiding by regulations.  My gamble paid off and I was herded onto the plane on the hi-low machine used for the luggage (pride abandoned long ago).  The next flight required me to hop up the stairs onto the plane; nervous that they’d deem me unfit to fly, I smiled to indicate I was oblivious to my foot’s screaming pain.

Upon landing, I went directly to Ealing Hospital.  My foot resembled the size and shape of a rugby ball and an X-ray (on a blood-free table) revealed a 15cm wire (the thickness of a coat-hanger) through its length.  The wire curved into a hook and protruded out from my toenail.  The consultant said simply, “Ah, well, we’ll have to get rid of that”.  Anticipating anaesthetic, I was shocked when he instantly yanked the wire and it came straight out – the damaged nerves meant I felt nothing.

Ironically, my allocated consultant was Egyptian.

Months later I was in a hospital gown, my toe due for amputation in two hours.  With a surge of inexplicable (and overdue) defiance, I discharged myself without proceeding.  Since then, another surgeon has tried to save my little toe by fusing it to the adjacent toe.  This also failed and another attempt at fusion is scheduled.  If it fails, then amputation will proceed as the toe is deformed, grossly out of place and painful.  But it’s not all bad … I’ve an undeniable crush on my current surgeon which I’ll explore when all this is over (though it’s my preference to be conscious for any future sexual encounters).

Afterword

The most common response to this anecdote is, “Why did you have the operation?! I would never have done that”!  Understandable – ordinarily, neither would I.  However it was a case of snowballing.  One moment a doctor was coming to the boat to strap my toe, the next I was being taken to the “international” hospital (which raised no real cause for alarm).  Then, after an attempt at non-surgical relocation, I was assured that it would be a ten minute operation and I’d be fine to go on my way.  Having come so far, I figured I may as well see it through – especially as it was such a quick procedure.  I didn’t foresee sexual assault during an operation lasting hours, undergoing three further operations and potentially being left with nine toes.