A man walks into my consulting room with a bouncing limp. He is tall and upright. He bows slightly and shakes my hand. The familiar courtesies.
I greet him: Salaam Aleikhum.
He responds: Aleikhum Salaam.
We exchange names. His name is Ahmed. He says: “My foot is painful. Please excuse me. I am afraid I must remove my shoe.”
His problem is visible through an opening in his sandal: the left great toe is infected. The flesh of the nail bed is hot and red, a crescent of swollen skin surrounding a sunken island of nail. The skin is shiny, stretched to bursting. A promising eyelet of pus peeps from beneath a corner of the cuticle.
The infected nail bed is about to burst in a flow of laudable pus. The pus will stink, Ahmed will feel better and so will I. Finally, a patient telling me a straightforward story. Finally a patient I can cure.
I treat the infection, dress the toe and ask Ahmed to return tomorrow to renew his dressing.
“I cannot come tomorrow.” His manner is politely regretful. “I will leave here tonight.” He speaks softly, practicality competing with swelling happiness: “I have my visa.”
Ahmed’s smile is a field of waving daffodils.
As it happens I will fly out tonight too. After three weeks of seeing patients here, Ahmed is the only one I meet to win a visa. The remainder reside in trailer parks of hope and despair.