Arwa arrives late to the clinic. Her husband is parked outside waiting for her.
“You missed your last two appointments,” I say, checking her records. It’s been four months.
“I didn’t have a ride,” she shrugs.
Many of my patients live close to the primary-care center in Kuwait where I work as a family physician, but the desert heat makes it impossible to come here on foot. Two minutes under the sun can leave you delirious, and if you have asthma, the sudden dust storms are a constant threat. Without an air-conditioned car, you’re essentially homebound.
I know this, so I don’t argue with Arwa.
Her husband is her only ride, and to bring her, he needs to take time off from work. His boss gets angry. Work accumulates. He gets mad at her. They fight over little things that stand for bigger things. Like the clogged kitchen drain. The car’s whining brakes. The money spent on his cigarettes. Their uneven mattress, whose coils scrape Arwa’s knees as she makes their bed each morning.
“I keep waiting for things to get better,” she says as I prepare a peak-flow meter to measure her lungs’ air flow.
“Is he still smoking indoors?” I hand her the cylinder to breathe into.
“He says smoking is the only thing that keeps him sane.” She removes a glob of gum from her mouth. “Then I ask myself, what’s keeping me sane?”
Last month, she delivered their third child, a boy, and brought him home to their one-bedroom apartment. With each pregnancy, her waist expands, making it harder to breathe. Her husband works three jobs, one for every child. She never went to college, never had a job and never regretted it until now.
“Don’t you believe them,” she murmurs, leaning closer, “when they tell you that money can’t buy happiness.”
“Three breaths,” I instruct.
She inhales deeply, her lips forming a ring around the device. She eyes the red pointer as I slide it to its starting point.
Her lungs whistle as she expels every ounce of oxygen she can. Watching her features distort with breathlessness, I mull over her words.
No, money can’t buy happiness, is my first thought.
Other thoughts quickly counter it: But money can buy comfort. It can buy a car that won’t break down in the middle of the road under a scorching sun. A car that will get you to your medical appointments on time.
“300.” I push the indicator back to zero, as if she’d never exhaled. The way she feels every morning, waking up to a list of tasks with no end, regardless of how hard she worked the day before.
No, money can’t buy you happiness. But it can buy a cushioned mattress that will be kind to your aching knees. It can buy bedsheets that won’t shed microscopic fibers that irritate your windpipe, especially when mixed with the fumes from your husband’s cigarettes. Money can’t buy friendship, but it can buy time. It can hire someone to cook your meals. It can pay someone to listen to your troubles and help to resolve your marital conflicts.
“330.” I slide it back one last time. She squeezes her lips and eyes tight shut against the force of her breath.
Money can’t buy health. But it can buy nicotine patches, gym subscriptions and access to a doctor who’s not overbooked. Money can’t buy love, but it can save you and your children from an abusive, selfish spouse or parent. Money can’t buy loyalty, but it can bring joy to the people you love. It can build affection when you share what you’ve worked hard to earn. It can create laughter that echoes in your memory long after the bills have been paid. Money can’t buy youth, but it can fund scientific research that determines which truths we will learn and which patients we’ll be able to cure….
“350.” I take the device from her shaking hands. Her bright pink lipstick is smeared all over the disposable mouthpiece. Unlatching it and tossing it into the garbage bin, I ponder the role money has played in my own life.
My great-grandfather was so rich, I’ve been told, that he used to light his cigarettes with banknotes. He was a cutthroat businessman, determined to wring a profit from everything. Relatives whispered different versions of his story–none with a happy ending. I learned that it was possible for someone to spend a lifetime accumulating wealth and then lose most of it in a series of unwise decisions.
As a girl, I would often look up at his faded picture in my great-aunt’s living room and wonder about this man whose genes inhabit my body. Was he a good man ruined by money? Or did money simply magnify his faults?
Growing up, I went to a private school. Most of my peers were oblivious to the outrageous cost of our yearly tuition–a four-digit number my middle-class parents made sure I knew by heart.
Were my better-off classmates happier than I was? At that point, it was too early to tell. We were all struggling to fit in, meet unreasonable expectations and make sense of our lives.
Later on, in college, the race began. Students discussed future salaries and private practices, lavish offices and ministerial positions. Boys put on ties, stethoscopes and sophisticated airs. We girls shed our dependence and spoke of careers.
“This is our lifeboat in the dark ocean of patriarchy,” we told each other. “No woman should need anyone else for money.”
Here I am, years later, and the answer lies in the contrast between my life and Arwa’s. I am independent. I live a comfortable life. And I am face to face with what could have been my fate had I been less fortunate.
I replace the peak-flow meter in its case and record Arwa’s score.
“Am I getting better?” she asks, rolling her gum into a ball between her fingers. I hear her unspoken plea: Tell me that my life is improving.
“You’re not getting worse.”
She plops the gum back into her mouth and chews it slowly, digesting my verdict.
Meanwhile, I wonder, What if, in addition to prescribing her inhaler, I could prescribe more income? She could save up to buy a car. She’d have time to exercise and lose weight; she’d breathe better. Her husband could quit his third job and help with the kids. With one less boss breathing down his neck, he might even quit smoking.
“We’ll reach 400 next time,” I say encouragingly. I’m relieved that at least the cost of her medication is covered by our public healthcare system: She doesn’t have to choose between buying diapers for her newborn or being able to breathe. In this part of her life, at least, money makes a real and positive difference.
Arwa coughs as she walks down the hall towards the pharmacy. Would having more money make her happy? I can’t say for sure. But I know that I wouldn’t be where I am today without it. It has changed my life; it could change hers.
Again, I remember my great-grandfather and wonder why money couldn’t make him happy.
Maybe happiness is not only about how much money we have, I reflect. Maybe it’s also about how we spend it. Maybe our happiness is the sum of all the right things that money can buy.
About the author:
Hind Almazeedi is a thirty-three-year-old family physician from Kuwait. Since completing her family-medicine residency in Kuwait two years ago, she has been working at Abdullah Al-Mubarak Health Center in Kuwait City. While in medical school, she created a newsletter called The Monthly Dose and served as its editor-in-chief for three years. “Writing about the emotional experience of being a doctor and the value patients’ stories bring to my life has helped me to redefine what medicine means to me. As an Arab woman who is a physician, I write stories to reflect on social issues rarely discussed openly in my society and to provide a forum for voices that might otherwise never be heard.”