In Unfamiliar Territory



In the Land of the Invisible Women: A Female Doctor’s Journey in the Saudi Kingdom
by Qanta Ahmed
Sourcebooks (2008), 464 pages



The U.S. cover of Qanta Ahmed’s memoir In the Land of Invisible Women features a woman’s head shrouded in a black headdress against minarets and skies. I can’t help but wonder, since the subtitle is A Female Doctor’s Journey in the Saudi Kingdom, whether it might have made more sense for the cover to show a woman with a stethoscope against a Saudi hospital, or an operating room; that is, a cover that better reflected the memoir’s subtitle, rather than the usual clichéd woman in a veil. Because I wanted to read something other than an exposé on the subjugation of women in Saudi Arabia, it was with some reluctance that I took a chance on the book.


My chance proved to be illuminating, if not entirely satisfactory.


Ahmed’s memoir recounts the challenges she faces and people she meets in the two years she spends in Saudi Arabia working as a doctor at the National Guard Hospital in Riyadh. The absorbing opening sets the indignant tone:  an elderly Saudi Bedouin lady lies on an operating table while her young son hovers nearby to make sure that his mother’s veil does not slip. The opening also illustrates the overwhelming issue I had with this book: Ahmed is a Muslim in a Muslim country, and yet she seems confused.


In fact Ahmed often comes across as woefully ignorant of patriarchy and even basic cultural mores in a Muslim country. For example, when a young girl in Mecca informs Ahmed that she has memorized the Quran, Ahmed is skeptical—the only person she has ever met to have accomplished such a feat is her elderly grandfather. Considering that most Pakistanis—indeed most Muslims—are usually cognizant of the fact that rote memorization of the Quran can begin at even a preschool age, Ahmed’s disbelief of the girl’s assertion is striking. That Ahmed would not have such a basic cultural knowledge compels the informed reader to wonder what sort of a family/religious structure she was raised by, if only for the sake of understanding from where Ahmed’s ideas stem. But the reader does not understand, and so plods on, unmoored and off course.


Although Ahmed does sporadically mention that she fought patriarchy to get where she is, she fails to offer any particulars. This omission leaves the memoir severely lacking, for we have no context in which to place Ahmed’s emotions. In the following quote, for example, Ahmed contrasts her nail varnish with that of a Saudi girl’s henna stained nails. Ahmed espouses that, for all their differences, their colored nails symbolize their similarities. Which similarities exactly? Because Ahmed provides no information about the “follies” in her life or how she managed to overcome them, we are left in the dark: 

Small brown hands were clenched in a sleeping fist. I unpeeled them and looked at the stubby, anemic, orange-tipped nails. This color I knew to be henna. I looked at my own hands grasping hers, my glossy, noired nails contrasting against her orange manicure. Mine were Western, hers Eastern, so different yet both seeking the same folly: to change the color of our nails.




For Muslims, the holy pilgrimage of al Hajj, which takes place annually in Saudi Arabia, is a must, and so Ahmed heads off on her maiden religious pilgrimage. The author’s observations on this journey are informative and interesting, but they too suffer from insufficient knowledge of Ahmed’s religious upbringing. As such, we are unable to understand her concerns, motivations, or indignations. Once again, Ahmed’s cultural naiveté is marked when she expresses shock over seeing classism firsthand:


The entire point of Hajj was to remind Muslims of our equal status in the eyes of God and the only God determines if one Muslim is superior to another in matters of purity of His believer’s hearts. Hajj was not an exercise in dominating the weak because some form of economic power which, unlike each maid attending us, few other women in this tent actually earned for themselves.


Ahmed’s innocence is exposed again when she discovers that Saudis and Muslims may actually find lighter complexions to be more attractive than darker skin. Since this is a commonplace preference in Pakistan as well as in Pakistani expatriate families like Ahmed’s, it again makes the reader long to know more about her background. Has she never visited Pakistan? Has she never come across colorism in her own community at home? Or have her parents sheltered her from all this, and if so, how or why?


Worse than this, these women in my tent were feeling racially superior to the maid and perhaps even to me. I shouldn’t have been stunned. I had already uncovered some racism in my time in the Kingdom … Skin color, previously something I had never considered in my years of living in the United States or England, had somehow invited discomfort to me in Riyadh.


Ahmed reports on the treatment the elites dole out to their maids, yet it is a shame that she neither visits the maids’ homes nor reaches out to them. In fact, her book would have been far richer had Ahmed interviewed, included a chapter even, of menial workers in the Kingdom, such as the Filipino janitors. As the book stands, however, Ahmed only interviews the Saudi elite with whom she socializes.


To her credit, when it comes to the Saudi elite, Ahmed does an admirable job of exploring the issues they face, especially that of gender discrimination. Many restrictions are, in fact, gender-specific, notably that women may not drive in the Saudi Kingdom. Indeed, encouraged by the Arab Spring in 2010, Saudi Women’s groups held widespread protests for their right to drive, but to no avail. Also to date, a woman continues to require written permission from a male family member before she can legally travel outside the country.


Despite her intimacy with the crowd, the Saudi elite Ahmed chooses to highlight often come across as stock representations: this woman represents a veil-wearing, successful doctor; this woman represents a maverick because she talks loudly of taboo subjects at parties; this man represents a close-minded bigot who cannot tolerate a female doctor, let alone bear her diagnoses. Moreover, Ahmed’s prose is often weighed down with clichéd descriptions, such as all the Saudi elite being described as “drop dead gorgeous.”


Ahmed does offer, however, an incisive look at love and dating in the capital city, Riyadh, a territory navigated between overt social restrictions and covert freedoms afforded by technology. For example, although religious police make it a nightmare for single men and women to even dine together in group settings, these singles are nevertheless able to communicate freely via text messages, e-mails, and Bluetooth technology. Such duality makes for a schizophrenic society, a state Ahmed ultimately concludes is most detrimental to females because it renders their impressions and expectations of love immature and high-schoolish, especially among those women who have long left the high school life behind.



Where is the Outrage?

Ahmed does a decent job of illustrating how women, no matter how privileged, are molded by the restrictions imposed upon them. It is distressing to read about Reem, a bright and capable surgeon who does not attend a conference in Europe because her supposedly supportive and enlightened father refuses her the mandatory written permission. Furthermore, when Reem is accepted by the University of Toronto to study vascular surgery, her father permits her to go only if she agrees to an engagement or marriage. As a Westerner with ideas of women’s independence, we (and Ahmed) expect Reem to be furious; instead she is quite the opposite. Ahmed writes:


I couldn’t believe a woman so intelligent (as Reem) could be so stupid and so weak. Why couldn’t she defy her family, like I had been able to? Why were women so spineless? And why were our own mothers so eternally silent? To where in the world had all the maternal indignation gone? I could tell from my trembling voice there was more feeling in me than just about her situation. I was thinking about every snatched opportunity I had to claw back towards myself, always fending off the specter of arranged marriage with a pitchfork of determination and defiance.


”I have no options, Ahmed. If I don’t agree, my father will not approve my exit visa application, and I cannot enter Canada. I have wanted to pursue vascular surgery for years now, and I am not going to be stubborn about it. If I have to marry, I have to marry, I see no problem with that.”


Reem is a fascinating example of how educated Muslim women come to terms with living constrained lives. Indeed, resignation (comfort, even), rather than anger, is an emotional tactic often adopted. Reem’s consequent engagement shows, in all its giddiness, the real cost of gender separation. The reader would benefit to hear more of how Reem reconciles with the decisions she ultimately chooses—that is, if one can call her decision making autonomous.


In fact, in a book that tries earnestly to reconcile individual desires suppressed by collective restrictions, the lack of indignity is surprising. One of the few passages where Ahmed’s emotions finally jump off the page are when she speaks of mothers and the role, or lack thereof, they play in their daughter’s lives.  


My voice was filled with undisguised anger. I couldn’t believe a woman so intelligent could be so stupid and weak. Why couldn’t she defy her family, like I had been able to? Why were women so spineless? And why were our own mother so eternally silent? To where in the world had all maternal indignation gone? I could tell from my trembling voice there was more feeling in me that just about her situation. I was thinking about every snatched opportunity I had to claw back toward myself, always fending off the specter of arranged marriage with a pitchfork of determination and defiance.


Could it be that outright rebellion is not the answer to all dilemmas, and that Reem’s pragmatic decision is an intelligent one rather than stupid or weak? But Ahmed sees nothing but problems with Reem’s thought process. Yet, when Mai, a young Saudi woman whom Ahmed meets at a party and describes as “spunky,” regales Ahmed with tales of “the rage right now in elective procedures,” i.e., hymen reconstruction, Ahmed fails to explore how her own conditioning might lead to her own conformist reaction.


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.


Ahmed touches on many other peculiar dichotomies amongst the Saudis, such as sons obsessed with their mother’s veils, or of divorcées who have divorced their ”we want to marry a second time husband,” but now themselves long to be second wives, and Saudis who speak highly of their Jewish mentors but who hate all Jews. Instead of pushing away her suspicions, it would make for a more introspective read if Ahmed examined the source of her discomfort.


As to the tragedy of September 11th, Ahmed’s retelling of post-9/11 celebrations in the National Guard Hospital make for a somber read, as she finds herself standing transfixed in front of the television with expatriates from Sweden, South Africa, India, the Philippines, and Canada. But, yet again, for all of Ahmed’s solidarity with the expats post-9/11, the narrative lacks depth, since we don’t know her relationship with the expats pre-9/11, or even with the ex-pats themselves. Ahmed does, however, illustrate the indoctrination against the West through a simple but forceful anecdote.


In the days following 9/11, I bore witness to an extraordinary fabric, uniting the most educated and elite of Muslims  to the weakest and least educated in shared hatreds…..A few months earlier in a compound video store, I was about to leave when I noticed a Saudi couple. The woman was wearing a hijab with her face uncovered, standing with her thobe-clad  husband … A daughter, perhaps ten at most, stood between them … I was surprised to notice the mother clutched an Al Pacino movie, The Devil’s Advocate. I had seen the film and knew it to be inappropriate for a ten-year-old. I had to say something. … “We know the ratings,” the mother said brightly, as though I had underestimated her. “That’s why we want our daughter to see it! …We want our daughter to understand all the things which are so bad about the West, and especially American. We want our daughter to be aware of all the bad things that come out of there for her own protection. I don’t believe in sheltering my daughter. We believe we should expose her to the true reflection of that corrupt and debased world.”


Ahmed tries to argue with the woman but finally gives up and concludes, “Privilege and foreign training, and excellent command of English, and opportunity were still no panacea for hate.”


Where Ahmed Succeeds

For all of its shortcomings, Ahmed’s memoir works best when she is morally outraged on behalf of women, such as anchor woman Rania al-Baz’s brave decision to appear on television in 2004, battered and bruised, but also lifting the veil off domestic abuse in the Kingdom.


Ahmed is especially outraged on behalf of children. Of the many heartbreaking stories she relates, the most poignant are of a five year-old camel jockey and an abused child returned to his abusive family. In these instances her moral indignation shines. The two chapters I found most moving, despite stilted dialogue, concern children who die as a result of rampant reckless driving.


From the chapter “The Lost Boys of the Kingdom:”


The child had been their eighth, a youngest son. He had been killed by the Mercedes which had carried the four men returning from a weekend of high jinks in Bahrain. These parents had lost another child in a motor vehicle accident only a year earlier. I listened, unflinching. Months of working in the traumatic environment of critical care in Riyadh had already numbed me. Children were killed every day. I watched the parents weeping and allowed myself to feel nothing. The cruel, tasteless expatriate joke was based in a hideous reality.


“What do you call a Saudi airbag?”


“A five year-old.”


And from the chapter “A Father’s Grieving:”


“I think, we think Raeef saw it and got so scared he couldn’t move. The truck was so big the driver didn’t see the child until he was almost on top of him. Raeef was hit by the fender and went up over the windscreen. It was horrible. The driver immediately stopped the car and was discreet, but he was a god man. He called to my wife and put them both in the car and drove them to the security forces. When I arrived there, his Suburban was standing at the ER entrance, covered in my son’s blood. I didn’t realize until later…” Hesham was inconsolable for a long time. Even under his tremendous grief, however, his weeping was soft and controlled. He was wrapped in a monumental silence of shuddering sobs…


Faris finally rose to the occasion and began sharing some of his monumental scholarship of Islam.  …“Hesham and Hyatt are being tested in the most difficult manner … There are three fundamental beliefs in Islam about the death of a child which Allah teaches us to make the parents’ suffering a little easier…”


[Hesham] “Did you know that it is said that a mother who has lost one child is being pulled to heaven by one hand by her deceased child? And that mother who has lost two children is admitted to heaven by her children, each of whom leads her through the gates by one hand? Raeef is pulling his mother through heaven even now. I try to tell her that, to make her feel better.”


The Diagnosis

Ahmed’s memoir is peppered with her deep desire to learn about Islam as if she lacks even the basic knowledge about the religion she was born into. Was her family not practicing Muslims? Alas, Ahmed does not reveal. In fact, despite Ahmed’s success at illustrating the social stigmas of Saudi Arabia, she unfortunately falls short in painting a picture of herself, an essential element of any good memoir. By the end of the book, all we really learn of Ahmed is that she is of Pakistani origin, that she grew up in the United Kingdom, was educated in both the U.K. and the U. S., that she has accepted a medical position in Riyadh for which she feels ill prepared, and that she is a practicing Muslim. For a memoir, that’s a barebones sketch. In the Land of Invisible Women will appeal to readers interested in goings-on in Saudi Arabia, but only at a superficial level. The author may as well have published a series of essays.



Islam, Memoir, Saudi Arabia, Women's Rights, Nonfiction