my first walk in mosul

The absent sounds of bullettes did not take long and came back to my ears.. gunmen attacked police station near the hospital on the third day in Mosul and vehicle ban was declared in the city and to my surprise my colleagues told me : it is a vehicle ban, a very good time to take a walk in the city, come on doctor let us go out..

I went with him cause he seems wise, and I was reassured when saw the high number of people in the streets walking all around as if nothing happened and children made the streets as a football stadium and everywhere you see youngmen with their plastic balls shouting and running in a chaotic happy way.. they are not organized, they do not like rules…

We saw an old minaret called "al hadba'a" which dates back to 1000 years as my colleagues told me.. to the Othman era..

We say many churches

Tomb of Younan prophet from outside (the prophet taken and then released by a big fish)

And walked in an old quarter of the city

comeing back to life in Mosul

I reached Mosul while it was raining, the Taxi was not alloed to enter the hospital due to some security causes so I walked for about 5 minutes under the rain… I was still worried because I did not saw Mosul before and was thinking about how would the hospital look like and whether the house of doctors will be comfortable… and above all that the travel from Baghdad to Mosul took 9 hours in car and I was very tiered.. but rain let me really feel am traveling, I was not prepared for this rain, it never rain this time in Baghdad, so I did not bring any umbrella or clothes to walk under this rain.. I walked few meters fast.. get wet enough.. I decided I walk at ease.. walking fast won't help.. I let that rain to take some of the sorrows of Baghdad away from my mind..
My first day in Mosul was good and the second day I was welcomed by my colleagues and senior psychiatrist (8 senior psychiatrists and 8 resident doctors in psychiatry) and in the evening what surprises me is that there is no sounds of bullets in the neighborhood..
I went out to the garden and took these pictures to IBN SEENA general hospital in mosul..

the poor neglected woman with mental disorder

It was late in afternoon and before lunch, at the peak of my usual daily headache where a man with 2 women (one is in wheel chair) entered my room and the man anxiously asked that I help them by admitting his sister (in the wheel chair) to the our ward (the psychiatric ward). I asked them to sit down and tell me their story and the brother start to speak with anxious angry voice, interrupted at the peaks by the other (well) sister… the woman in the wheel chair was drowsy, sleepy, gave me a poor eye to eye contact at first but then ignored me and all the other surroundings and seem to be very sleepy…the story came as this from the mouth of the brother:
Before 2 days she was completely normal, not completely normal…. I mean…she has mental illness since years … but she was stable… till 2 days when we went to visit her in the home she lives in with her other brother… we knocked the door but she did not answer… we were sure she was inside so we broke the door and found her lying at the floor and blood was coming out of her ear…

What ear? (I asked..)
Her ear.. (answered her brother)
I meant left or right? (I asked him again)
What ear? (he repeated my question to the normal sister which did not respond but start to gaze at her sleepy sister)

I was surprised by their story, I was surprised because they came after 2 days.. what did they wait for? Why they came to the psychiatry unit? How come they did not know the ear that was bleeding?...
They felt that am feeling surprised so the brother said:
Doctor we do not live with her so we do not know her condition good
Where is the brother who lives with her?
He has work..
That meant he can not bring her to hospital..


I decided that I exam the woman.. she was wearing hijab, I asked her permission to take off the hijab, she did not answer, I took it off slowly and to my greater surprise found dry blood around her ear, and large ecchymosed area (bluish area due to accumulation of blood beneath the skin), my friend doctor wisam was hearing all the conversation so he asked them to do skull x-ray. The brother told us:
Doctor please admit her!
First do the skull x-ray (answered doctor wisam).

Doctor wisam wrote the paper that will let them get access to the free service of the same hospital we were in… they did not thanked us.. they went… we went to lunch… after that we were called to see the x-ray and it was this x-ray:




There was a bullet inside her skull… we searched for the site of entrance of the bullet but there was no site but the external ear opening!!
Take her to the surgical unit (doctor wisam said)
Her brother answered with cold blood that let me feel my forearm hair erected: doctor am tiered from going here and there.. is the surgical ward far from here?

qween tree

these are more pictures of the queen tree

That day I felt fatigue and I was avoiding conversations with my colleagues preferring to sit alone in complete silence while letting my eyes getting lost into gazes that scan the surroundings without exactly knowing what they see, and my head was going as a blank blackboard, but you can find the traces of the old words that was written by white and other colorful chock by the hands of the psychiatric ward.. I let them write on my mind blackboard all they want, and it came as a panorama of Iraqi languages: Arabic, Kurdish, Turkish, Armani, Assyrian, and others all speaking there problems so the threads of their stories get tied in my head today to a degree that I preferred to give my self a rest from talking… I went blank….
After the lunch I found my self tired so I went to bed and to my surprise I fell in deep sleep for about 3 hours, followed by rest in front of the TV alone changing the channels while the TV sound is too low..
My colleague told me that it is time to go to have dinner.. I told him to go before me and that I will follow him.. I took my clothes on slowly hopping that my colleague will find a person to talk to so that he will not talk to me.. I went slowly to the room where we usually have dinner but I found no one there.. I heard voices coming from the window, looked and found that doctors are having dinner in the garden… I put my headphone on and opened the radio of my mobile phone on the Air Force Radio (of the US army) while I walked to the garden hopping I will be more isolated from the sounds outside.. and it was this song:

No matter how hard I try
You keep pushing me aside
And I can't break through
There's no talking to you
It's so sad that you're leaving
It takes time to believe it
But after all is said and done
You've gonna be the lonely one
Do you believe in life after love?
I can feel something inside me say
I really don't think you're so strong enough
Do you believe in life after love?

This song (by Cher named Believe) made me smile for the first time in that day while am interring the garden where a fresh cold air came into my face hitting deep into my nose reaching my soul from there… I took out the ear pieces from my ears and looked above.. sky was deep blue in a strange way, and there was a lonely tree at the corner of the garden, it is in deep green, its contrast with the deep dark sky was amazing, as if am seeing this for the first time…
I hided my smile so that I do not look more strange than am really is today.. But that sight reminded me how life can be beautiful..
I came back to my normal level of functioning and took my lunch to sit beside my colleague and start to talk to him and he was happy to have me back again talking again.. we talked too much about all the silly things that we can talk.. I was suddenly happy and laughing with a true joy and my colleague was happy for me.. as I noticed..

At night, when all went to sleep I went back to that tree… how wonderful it is.. in Arabic language the word "tree" is feminine so I will refer to the tree by "she"..
She is tall.. high…and slim from below and strait.. then at the half of her way to stars above her leaves start to rise pointing to the sky…
There are blue looking small headed flowers around the garden all looking to the tree as small servants look to their queen, the tree…

She got a sister standing in the nearby garden, who is little shorter and more obese, I think the queen is the older sister.. the wiser..
At night I took all these picture to her by my poor quality mobile camera… and the next morning I was completely normal so I went again to the garden in the afternoon to say hi to my magical queen which healed me yesterday and took this picture to her

Nightmare Comes True

Stressors differ from each other in their severity in the degree to which they affect us. Our perception of the controlability and predictability of our stressors, is important to us to assess the degree of severity of them. The more the uncontrollable the stress the more it is severs. The more the unpredictable the stress the more it is severe.

These days in Baghdad are very stressful, of the main causes (maybe the most important one), the uncontrolability and unpredictability of the explotions that start in the last year to hit unexplained targets such as a market of old clothes visited by poor people, or the street of al mutanabbee which sells books for the most peacful people of Baghdad: those who love art,

or explotion of an old important bridge in centre of Baghdad causing many cars of civil people to drwan in the river of Tigris in an never dreamt of nightmare, which all of a sudden start to be a fact,

or explotion in a bus station in a poor sector of Baghdad.....

When you see in the eyes of people these days in Baghdad you see terror, it is somtime silly to ask them questions that intend to assess mental state of depression or anxiety like: do you see life is beautiful? or is life worth living? caus eif one says no, you do not have enough evidences to tell him that life is beautiful and it worth living, adn here comes the worst when the psychiatrist become depressed and encouraging depression.

suicide in baghdad

am sorry I was wrong about the study of Dr. Simon A. Ovanesian, I said he did not mension the prevalence of suicide in Baghdad. I was wrong, he mensioned that in the last paper of his study. He considered the population of Baghdad as being 4.68 million, and the prevalence to be 1.6/100000

Secrets of my Country (part 1 IZIDIES)

This is a picture of an IZIDI holy place

Am 29 now, all these years I have lived in Iraq, my country which I love, I am also curious to know about its history, but inspite of that it was only before 2 days when I first met an Iraqi woman from the IZIDI religion..

Many people do not know what this religions is, including me, it is a secret, a lovely secret, and I do not know why.....

In all the previous era before the invention of the internet, it was very difficult to know things about the IZIDI religion, but after the 2003 war in Iraq and the easy access to internet therafter, we saw that many IZIDI people are talking about there religion in websites....

What makes me sad ius that I just know today that the first wednesday of this month (april), is a holy happy day for them and they make many beautiful things this day including going in the early morning to the flowers and taking the drops of water in it to there faces, and at night they join together in the holy place to light on candles.... all this occur in my country and no media shed light on it... no body, but the IZIDIES, now that there is a holy happy day...

I hope in the future cameras can find its way there to shed light on this beautiful colour of my country....

the following are pictures from IZIDI holy places in north Iraq

suicide in iraq

In Iraq it is rare to find an epidemiologic study regarding many things, and it very rare to find a study about the mental health, I was surprised that no study was done to know the prevalence of suiside in iraq, but there was a study by dr. Simon A. Ovanessian named "An Approach for Description & A Clue for Prevention" made in 1993, as you can see it was a long complex title that still I can not fully understand, but what he says that he was looking for the suicide cases which reach the baghdad foreinsic institute during a year from Nov.1991 till Nov. 1992, and there was 60 case from Baghdad only... and if we know that there are about 5 million people living in baghdad at that time, and that all the cases of suicide must reach the baghdad foreinsic institute, the prevalence will be: 1.2/100,000.....

But what surprises me is that dr. Simon did not mention the prevalence rate, he only gave us numbers... why he did not make the prevalence rate frankly?

Baghdad foriensic institute

Well it is again one of the stories which am writing with difficulty and till now am not sure that I should write this or not. In spite of the sadness and despair this story got, it is true, incredebly true.... I could not find a picture to publish it with this:

Before one year from now, I went to the colledge of medecine in Baghdad to do some work there, what I noticed is that there is a smell of dead bodies! I did not ask anyone about that smell because I was affraid from the answer... But everybody was acting normally, many female students was in full make up and wearing sexy clothes, many male students were laughing strongly about some jokes they made.... so I decided to ask about the smell of the dead bodies... I had asked a police man, he told me with a strange look in his face: the smell come from the baghdad foreinsic institute..he seemed surprised that somebody asked him about that.... when I finished my job I went out fastly and did not want to know more till before one month....

Before on month a patient came to the psychiatric outpatient clinic in the hospital I work in, he was working in Baghdad foreinsic institute, and he was severely depressed with severe symptoms of posttraumatic stress disorder, he had quit his job, can not go out of his home easily, difficulty to sleep, many flashbacks, poor comcentration, his eyes were red and widely opened.....

I asked him about things he saw there, he told me things that I can not till now imagine that a human being can do it to another human.... he told me how they receive dead tortutured bodies, some of these bodies seemed tortured with a sense of pleasure or luster or i do not know what to call it...

I want tell you what he told me.... cause sometimes it is better not to know

on the left you can see on of the biggest baghdad hospitals.... "the city of medecine" ....which i can not iclude all of it in the view, but i had icluded the picture of Hayifa street which is on the other side of the river Tigres....... where some fights in guns occur between different people including US army, Iraqi army, and different iraqi militias.... well..... i hope this gonna end fast and we can rest in peace again...

am sorry to give you this pictures which contain these ugly frightenening bullets ........ but i just wanted you to know that I have found these bullets in the floor of the hospital .... not in the yard i mean but near the hospital...... on of these bullets.. the one on the left ... had entered into the collidor of the "house of doctors".... the place where we sleep at night if we are on call,,,, the apple and the glass of water is to tell you that life is goning on..... and the books are some of my terxtbooks in psychiatry..... sorry again to show you such an ugly picture ... but i see these bullets every now and then....

Reading With The Sounds Of Bulletts

These days I work in Baghdad Hospital in a place called City of Medicine..... It lies on the river of Tigres..... on the other front of the river is a street called Haifa street, on the name of the palestenian (now israeli) city..... In that street many battles occur from between the houses where some gun men live and between the US army or Iraqi army or both.... some bullette always find there way to the city of medecine where I live, work and study these days..... even if you are optimistic enough to think that no bullette will hit you... the sounds of the explotions and bullettes are very stressfull... i remember i have asked a patient with post traumatic stress disorder on her first day of admission if she is afraid NOW... and as I said NOW... a sound of an explotion and many bulletts came to our ear and the patient took a deep breath and did not answer.....

Skinner and personality

While many psychiatrists and psychologists and others devoted there working time and may be there lifes to define personality.... Skinner defined it simply as learned predispositions to certain behaviour.... he uses the term behaviour instead of the terms like EGO, ID, PERSONA, and prefer terms that can be mesured in experiments in the laboratory.....

Normality of the Psych

Normality is a central issue in psychiatry. It is defined in psychiatry as easy as the absence of signs and symptoms. That is very practical. Yet in psychology normality is not that easily defined. Some psychoanalysts seem to define normality as being ideal or living in Utopia. Freud had put a good definition by saying normality is the ability to love and to work. Normality can be seen from the perspective of how the majority of a given society feel and behave regarding the minority as abnormal.

first city in the world

The first city in the world is ERIDU, the sumerian city in the south of Iraq.

Read With The Candles

In Iraq we live without contiuous electricity power supply since 1991. That means that all the Iraqi students must have sometimes studied at night on the light of candles. Iraqis had been known since long time as good readers. It was sayed that Cairo reads, Beirut publishs, and Baghdad reads. Since years and Iraqies read at night with the candles' light.









That was my picture reading a newspaper at night with the light of a candle. These day the national electricity supply is only about 8 hours a day. The rest of the time we take elecricity froma local electricity generator for which we pay about 4 US Dollars for the one Ampear.














This is the picture of our local elecricity generator. It makes a lot of noise and waste products but we love it and can not live without it especially in the hot summer nights.

Evidence Based Medecine EBM

There are many who thinks that in psychiatry, scientists say whatever comes to there mind. I have heard many people who mistrust this branch of medicine. These people sometimes are unfortunately working in specialities got many things in common with psychiatry like psychology, sociology, philosophy, pharmacology, and most unfortunately some medical doctors!

There is what is called as EVIDENCE BASED MEDECINE since 1980s or maybe before. To make it simple to understant what that means let us explain it this way : the facts in medecine these days always contain NUMBERS ! e.g. we do not say these days that schizophrenia run in famillies, but we say like this " in a classic twin study of schizophrenia, Gottesman & Shields (1972) found in their sample 11 concordant and 11 disconcordant pairs of monozygotic twins and 3 concordant and 30 disconcordant in dizygotic pairs of twins".

This makes information in all branches of medicine more near to the truth if not absolutely true. And these days all the information that came from the past is retested and many theories had been rejected because they could not be proved in experiments.

And I heard alot about people saying nonsense about psychotropic drugs. I have heard a well know psychologist in a famous arabic T.V. channel says that antidepressants lead to irreversible intoxication and dependency. Do not believe that a drug is still being sold in the market and there is a prove that it causes too much harm than its benefits. And many of us had heard stories about how drugs were withdrawn from the market as soon as a dangerous side effects were reported.

But remember that all drug if not used right are dangerous.

Few Words of the Mute

Listen to this story of a mute teenager from Iraq with her mother:

In the psychiatric ward a beautiful teenager girl in her 15 lies silently in her bed. While me and Dr. Abbas were entering her room, she stayed still without motion, only her big beautiful eyes followed our entering. Her mother seems depressed and also did not move when we entered the room. The girl did not answer our greeting. We asked the mother about the problem. She told us that her daughter, who is mentally retarded had become mute again before few days. The girl who had a deformity in her feet was diagnosed as having a mental retardation since she was 8 years old. And because of there is no special school near the place she lives in, she stayed at home with her mother. She was the only child of this woman. The mother told us also about the birth of this girl. When the mother was in the last days of her pregnancy, she new that her husband whom she had lived with only for 2 months had died in the gulf war in 1991, and while she was shocked by that news she felt strong abdomenal pains. After few minutes she was having a difficult labour that ended with this handicaped beautiful girl. The mother had not been married again. We asked the mother about the last words said by her daughter. She told us that when they were coming to the hospital, a mini-bus had exploded just few meters beyond them and no shell had hit them. At that moment the girl said just few words:" mommy, if we were just few minutes late we would have been lucky to be dead both of us and get rid of our lives"

What Do You Think of Psychiatry?

When I was in the fourth year in the colledge, my uncle asked me about which speciality in medecine I like. When I answered : PSYCHIATRY, my uncle's face turned into yellow and he took a long time of silence as if something dangerous or wrong has happened. Then he told me that no one will visit me to my clinic if I will be a psychiatrsit. That was not strange especially if you know how people in Iraq look to this speciality.

I remember one of the best doctors whome I was working under his supervision, I liked him very much, and respect his point of view . When he knew about my decision to be a resident doctor in psychiatry he was surprised and told me : but Sami listen, what you gonna do for crazy people? they do not need you.... they got the street open to them to run in it....no one will come to your clinic!

A friend of mine who also chosed psychiatry as a career told me about the minute his father knew about his choice of studying psychiatry, his father told him: if you chose this branch of specialization, I will no more be your father!

And that obliged my friend to postpone his studies for one year so that he will not lose the love of his father, and fortunately during that year he succeeded to change his father's point of view. In Iraq it is considered very bad to make your parents discontent about you.

As you see from the above story, in Iraq , the picture of psychiatry is still not clear to peolple and many think that the psychiatrists themselves got some kind of mental illness.