Preemptive Love CHAPTER 1 Chai in an Iraqi Hotel
How many times have I sat behind the ominous blast walls in this Iraqi hotel? Will I really be protected if a car bomb goes off outside? (I would get that answer soon enough.) The gaudy orange decor was offensive at first, but I eventually resigned myself to it. It can be so difficult to see things for what they are, even more so to see what they could be.

I never had a room there at the hotel. Unlike most of the journalists and aid workers who frequented the hotel, I wasn’t on assignment. With our families expressing deep concern over the targeted killing of Christians in Iraq, Kurdish-Arab tensions on the rise, and the Sunni-Shia civil war in full effect, my wife, Jessica, and I felt compelled to take our beautiful baby girl and move to Iraq.

We lived in a house down the street from the hotel, in a neighborhood called Peace.

In the winter, when the neighborhood only had about three hours of electricity per day, our home was frigid and dark. But it taught us an invaluable lesson: we don’t need power to live in Peace.

Sure, we longed for power. It would have made everything easier! We even bought a small gasoline generator to run the lights and our computers, but using it was like announcing, “We have money, and you don’t!” So after a few can’t-live-without-it moments, we decided not to use it again.

The spring was pleasant, but by the summer our house had become a brick oven. Jessica was pregnant with our son while trying to care for our daughter. Most days she navigated life in Iraq with little or no water and electricity. Without a working knowledge of local languages or a car to get around the city, she felt like a prisoner. It was becoming increasingly clear that we had not chosen an easy path, and our marriage was suffering.

One thing that simultaneously made my life better and her life worse was the hotel up the road with its Hollywood classics on the lobby big screen, air-conditioning, and table-side tea service. The hotel served as an office for my work with war widows, but also as a place of retreat from the difficulties of life outside. It gave respite. It was an oasis, far away from some of the difficulties of life in Iraq. If my clothes smelled of burned coffee and other men’s cigarettes when I walked in the front door, Jessica knew where I’d been. And I could pretty much guarantee I wasn’t getting that “Honey, I’m home” hug. If there is one thing Jessica cannot abide, it is the feeling that everyone is not getting their fair share. And she certainly was not getting hers.

It was Jessica’s beauty and her utter lack of pretension that first drew me to her in college. But it was her passion for fairness that kept me close. Sure, I found it easy to mock (“Life’s not fair!”) as I awkwardly groped for attention and security with a woman who was utterly out of my league. But there is something completely enchanting about a woman who believes that life should be fair, not for her own sake, but for the sake of everyone else. Still, talk is cheap. Few women are serious enough about fairness and justice to run toward the broken, forgotten people of the world. That’s Jess. She doesn’t have a vapid bone in her body. And it was ultimately her character and conviction that compelled us to move to Iraq.

But conviction and naivety are good friends. We nearly destroyed our marriage trying to help everyone else. Like a Scud missile through the roof, our marriage came crashing down around us during a terrifying yelling match in 120-degree heat where I thought my life was ending. But things were about to turn around.

I imagine it took days for him to get up the nerve to approach me. He probably had to talk himself into it, given the changing perspectives on Americans in Iraq and our inability to speak each other’s language. He may have even rehearsed his speech a few times.

I had been visiting his hotel café for months. We were familiar with one another, even friendly. But on this particular day, he had a favor to ask. In and of itself, this was not unique. I was constantly asked to give money, sponsor a green card, or teach English. Most of the Iraqis I knew were very accustomed to being rejected for these things. There was not often a lot of push-back or sense of entitlement for many of the favors we were asked to bestow. But this guy was different. I remember him being fairly solemn—as if it really mattered and he wanted to get it right.

As he nervously asked for permission to present his request, I remember thinking . . .

Nothing. I don’t remember thinking anything. This was just another conversation for me. I had not been building up to this for days. I did not have anything riding on this conversation. I certainly did not know that his request would change my life forever.

“Can you help my cousin?” he said. “His daughter was born with a huge hole in her heart, and no one in all of Iraq can save her life. Can you help?”

If you are like me, you hear heroic stories and you wonder, What would I do in that situation? I’m sure I would wear the white hat and save the day.

My answer to his earnest appeal came quite easily.

“I can’t help you. I don’t know anything about that.”

I did not need any rehearsal time. My list of justifications was waiting at the gate to be unleashed.

∙ I’m not a doctor.

∙ I’ve never done that before.

∙ I don’t know anything about sending children abroad for treatment.

∙ I don’t have that kind of money.

∙ My organization does not handle situations like that.

At this response, my friend (he was obviously more a friend to me than I was to him) could have attacked my character, quoted how much money I had spent on coffee and tea over the past months, lambasted me for my hypocrisy, or come at me just for being an American. Instead, he did the exact opposite. Rather than condemn me, he praised me. Like Jessica and her conviction that the world should be fair, he was totally disarming.

He appealed to my obvious desire to make things right in the world and said, “Mr. Jeremy, you are an American, right? Clearly you didn’t move your family to Iraq to say no to people. You want to help people. You are a good Christian. You did not move here to say no. You moved here to say yes. Please say yes to my cousin, Mr. Jeremy.”

There was so much fear in my initial rejection of his need. I was so unsure of myself and where I stood in the world. I was not a leader in my organization, and my marriage demonstrated how lame a leader I was in my own home as well. I was so vulnerable to any number of attacks that he could have launched. He could have won the argument by laying waste to me and my attempt to hold his family’s suffering at arm’s length. But he was interested in more than scoring points for the home team. He saw a life in the balance—a little four-year-old girl whose mommy and daddy loved her very much. He did not care to be “right”—he cared about saving her life.

And his insight cut my hardening heart and made me alive again. I did move to Iraq to help people. I did not move to Iraq to say no. I was convinced that I could make a difference, and I intended to say yes as often as I could.

Jessica always says, “You catch more bees with honey than vinegar.” He clearly believed the same thing. I reversed my answer. He disarmed me, and I said, “Yes!”

A few days later I was back in the hotel lobby to meet with the cousin and read the medical reports. I had no idea what I was doing. I couldn’t read a medical report to save my life. I didn’t have a background in social work. I was a complete novice.

As the cousin walked through the door of the café, my heart melted. He had brought his little girl with him—the best decision he could have made. When I saw her, I thought of my little brown-eyed girl, Emma. Was there anything I wouldn’t do to save her life? How many doors would I knock on? How long would I beg? To what degree would I debase myself to see her live?

I was a goner before the meeting ever began.

I stood up to greet the man—a kindhearted father a few years my senior. He was shorter than I; I think he had a mustache. He was gentle, respectful, and very guarded, as though a single misstep on his part could cost his daughter her life.

I realized how little I understood about the world, about power distribution, and about how it feels to be completely at the mercy of another.

It’s amazing how many thoughts can go through your mind in a few minutes. As I think back on that meeting, I have this image of myself begging on the street corner for money to pay for my daughter’s surgery. I don’t think I’ve ever done anything altruistic in my life. Everything I do is probably motivated by some sense of guilt or out of a desire to stave off my own demise. It is hard for me to ascertain whether I was compelled to help this dear man because I saw him in need or because I conjured up an image of myself in need.

We regularly tell one another to “put yourself in their place” or “walk a mile in their shoes.” I saw myself standing in his shoes, on the corner, begging for change with my little girl in my arms. I was terrified. But I don’t think I was terrified primarily for him. I think I was terrified for myself.

Whatever the case, I was moved by the idea that this little girl could die without someone who would take the risk and intervene. And I knew I would want someone to take a risk for me if I was the one holding my Emma in search of surgery.

The medical reports were unclear to me. The field of pediatric cardiology was nonexistent in Iraq as a subspecialty at that time. My impression was that she had a hole in her heart. That sounded bad enough to get my attention—it seemed reasonable enough to assume that major organs were not supposed to have extra holes in them. If the reports had been more technically accurate, they would have flown over my head altogether. But the idea of this little princess struggling to walk and play and breathe because of a life-threatening hole in her heart was enough to inspire me to jump in with both feet.

I had not named it yet—that passion and joy that caused me to suspend my questions and fears. My military friends had mantras like “Better to be judged by twelve than carried by six” and “Shoot first; ask questions later.” But I had watched Iraq destroy nearly all the people who allowed themselves to live in a constant state of suspicion or cynicism. So I adopted my own motto: “Love first; ask questions later.” Today I call it preemptive love.

Nothing had changed in my actual capacity to help this dear family. I still wasn’t a doctor. I still didn’t know anything about sending children abroad for treatment. I was wealthier than he was, but I still didn’t have enough money to pay for her surgery on my own. And my team was still focused on helping war widows—not medical treatment for children. What had changed was my heart. I moved from a policy of risk management and calculated charity to a way of life that seemed much more like the Jesus I had grown up hearing about on my nona’s lap as my nono preached from the Bible.

I promised to take the medical reports and knock on a few doors and make a few phone calls to friends. If I had one thing, it was a network of foreigners who might have access to better information than I. But I also made one more promise: I looked the father in the eyes and promised him that I would fail; I promised him that I was not going to be the one to turn up any results.

This may seem like a strange, even cruel thing to promise. But I had seen enough good intentions during my brief time in Iraq to know that good intentions are not enough. I had seen Americans swoop in and promise the moon and then fail to deliver. They always meant well. I wanted to help. But I did not want to be one more person to make promises that I could not keep. So I did the opposite.

Underpromise, overdeliver.

He gave me the medical files and a CD of data in a manila envelope. I imagine he went home and celebrated with his family. This was the closest they had come yet to saving their daughter’s life. I hoped his family looked at him differently that night—with pride and with confidence that he could get the job done to protect and provide.

Deep down, I hoped that helping this little girl would cause Jessica to look at me again with pride and trust that I could protect and provide for our family. After the rush of emotions wore off, helping this little girl became a mostly perfunctory task for me. I still had Hollywood visions of lifesaving, and this did not fit the bill. I was younger and more naive than I am now, and I did not yet realize that paperwork saves lives. Police officers save lives. Firefighters save lives. Surgeons save lives. But people who push paper around? Well, I would do what was required of me, but I certainly did not see it as a task that was likely to make much of a difference.

As I made my inquiries of foreigners in the community who were experts in their fields, I started learning shocking details and claims about the legacy of birth defects in Iraq. Every major Iraqi community had a different story to account for the apparently high rate of birth defects. Still, their stories from north to south and across ethnic and religious lines had one thing in common: almost everyone interpreted their sick and malformed children through the lens of various violent acts that were done to them by “the evil other”—that sometimes-hard-to-define group of people who are, at their core, not like us. Almost all my interviews and encounters flatly ignored the more mundane factors and known causes that are common worldwide. Instead, most derived a cathartic sense of meaning for their child’s sickness by concluding it was a result of war and violence.

And this was not without good cause, as I would learn in coming months.

I had recently met a guy named Cody who worked for a different field office—the Halabja office—inside our broader relief and development organization. He was fresh off the plane from California. I remember thinking he was both daring and perhaps a bit of a pie-in-the-sky dreamer when I saw him walking around with a book of poetry in the language of the local greats.

Surely he can’t read that? Hmph. Show-off!

The details of what happened next are a little hazy. But we don’t always know the major junctions at which our lives will change. I must have been casually getting to know Cody and the work they did all the way out there in the Halabja office. Knowing Cody the way I do today, I can guess that he probably gave me some impassioned sermon about rehabilitating people still suffering from Saddam’s chemical bombardment in 1988.

Saddam’s chemical bombardment of Halabja in 1988? My mind trailed off as Cody talked. I could not recall that I had ever heard anything about it. It is only now in retrospect that I can understand how ignorant and offensive that is to my Kurdish friends. At the time, however, it simply wasn’t on my radar. Unlike many of my colleagues (including my wife, who studied the events in graduate school), it was not a factor that compelled me to feel compassion for the Kurds, nor did it cause me to move to Iraq in hopes of making a difference. I vaguely remember Jessica’s late-night retellings of Saddam’s atrocities as she would read her books or verbally process the mind-blowing lecture of the day by Dr. Marc Ellis at Baylor University. But the gassing of Halabja never got under my skin—never seeped into my soul—the way it did for others. I was busy studying theology at the time.

Then Cody mentioned something about trying to help children with heart defects. He had my full attention.

I told him the story of my encounter with the little girl in the hotel lobby, and Cody began to connect me with others on his team who had a little more experience helping kids with broken hearts. He snowed me under with a lot of things that I didn’t understand—something about collecting medical files from across the region and sending them out to doctors in Jordan for evaluation. He mentioned a desk in their office that was piled up—his hand went above his eyes like an elevator—with reports from hundreds of children who were waiting in line for lifesaving heart surgery.

Waiting in line . . . I’ve never had to wait in line for much of anything. I’ve waited in a waiting room before. But I had an array of Highlights magazines and a comfy-enough chair to sit in at least. I’ve waited on hold with the credit card company while I flipped through an array of television stations. I’ve waited for food at fancy restaurants—but I always had a reservation for the table itself before my wife and I even arrived. There were a number of times in Austin, Texas—the Live Music Capital of the World—when I waited in line for a concert, but I already had my tickets in hand. My entrance was guaranteed. I’ve never truly waited in line the way these mothers and fathers did.

At that time, there were few diagnostic tools available in Iraq. Most cardiologists and pediatricians in the country—particularly in the Halabja region, where Cody worked—were diagnosing heart defects blindly with a stethoscope while the rest of the developed world was using ultrasounds, magnetic resonance imaging (MRI), computerized tomography (CT) scans, and catheterizations. There are a few phenomenal doctors out there who can perceive anatomical malformations by placing an ear on a child’s chest, but there is nothing like a qualified doctor really seeing a problem when it comes time to solicit support to save your child’s life.

Most doctors in Iraq never really knew what was wrong with their heart patients. In spite of the fact that there are scores of distinct heart defects and defect combinations, the vast majority of the population still says their child has a “hole in her heart”—a product of each doctor’s inability to truly see and understand what was going on inside a child’s body after decades of sanctions, war, and mass exodus among the country’s most knowledgeable medical experts. Like any father or mother looking out for the interest of their family, a huge number of Iraq’s medical elite escaped Iraq as soon as they saw the writing on the wall—in the late 1970s as Saddam Hussein ascended in power and became more caustic toward Iran, in the late 1980s as Saddam bankrupted the country and ultimately invaded Kuwait, and throughout the sanctions era as children starved to death and the UN pursued its doctrine of “containment” to its most extreme ends. Many of those doctors who could escape did. Of those who stayed, many were assassinated in the sectarian divide that opened upon the fall of Saddam.

When a child’s medical report landed on the pile on the corner desk in Cody’s office, the vast majority of them simply said “needs surgery”—hardly a viable medical diagnosis upon which to base the triage of children.

So as these parents waited in line, they were not merely waiting for lifesaving surgery. They were actually waiting for a proper diagnosis, living each day with a child who couldn’t walk to school or whose skin was blackish-blue from a lack of oxygen. Obtaining a proper diagnosis was a bit like playing Russian roulette, a one-in-six chance that a child would be severe enough to catch someone’s attention and rise to the top of the waiting list. Of course, if they were “lucky” enough to actually have a heart defect that demanded immediate attention, it often meant the child was very sick and very risky. I would soon learn that these were exactly the kind of children that aid offices like Cody’s and the charitable hospitals with whom they worked were most unlikely to accept.

Paradoxically, the kinds of children that the hospitals and aid groups often prefer to help are the children who are sometimes least likely to find their way to a doctor’s office in the first place. They are the ones who have ticking time bombs in their chests that absolutely must be repaired, but they lack the blackish-blue skin and lips, the deformed finger- and toenails, or the obvious exhaustion and breathing problems that result from certain defects. When war, terrorism, and underdevelopment create an impediment to routine checkups and proper diagnoses, these preferred children are the very ones who never make it onto the list at all.

I remember the day I visited Cody’s office and saw the pile of reports. It was an overwhelming sight. I gave my manila envelope to Cody’s friend as he explained a little more about how they had to wait on the once-a-week commercial flight into and out of our city to send a stack of files to a partner organization in Jordan. There was no FedEx or DHL. In Jordan, doctors would peruse the files and select those who seemed likely to fit their final selection criteria. If there were hundreds of cases for consideration, a group of twenty would be selected to come to Jordan for a real diagnostic evaluation. It wasn’t clear to me who paid for the travel or how long it took to organize a massive trip to Jordan at a time when Jordan was claiming millions of refugees from the Iraq War. Who handled the visa applications? Who guaranteed the patients’ return to Iraq?

In any case, upon arrival in Jordan, a portion of the twenty would be found to be too risky. A few might actually be given a clean bill of health—maybe there was a misdiagnosis or a self-correction of one of the more minor defects. Those who were determined to need surgery would receive their official diagnosis and be told that the organization would try to help provide surgery for them within the coming year.

Depending on available funding, a few were taken immediately to surgery and the rest of the group returned to Iraq to sit and contemplate their lot. By my later estimations, almost all of them returned to wait in line again, regardless of what the doctors in Jordan said. If their child was too risky, then they had to keep searching for solutions elsewhere. But we also learned that a “clean bill of health” was an incredibly difficult thing to accept once you’ve resigned yourself to the idea that your child is living on the brink of death.

What if the doctors in Jordan were wrong? Is this Jordanian subterfuge because I’m Iraqi? Arab subterfuge because I’m Kurdish? My child is probably still sick—I should never give up until I find someone willing to give my child the surgery I know he needs.

Even those who were selected for surgery would often doubt the intentions of the organization or would play the field to see if there was any way to expedite the surgery through another avenue.

Why take any risks after all that we’ve seen in the last few decades?

I looked at the towering stacks of files on the desk. They reminded me of the collapsing Twin Towers on September 11, one of the driving forces that had helped land me in Iraq in the first place. It was hard to imagine someone getting on a commercial flight with a bag full of files. At once it seemed innovative and harkened back to images of the Pony Express. But what would become of those who were literally lost in the shuffle? I think I remember seeing an envelope that had inadvertently fallen under a nearby table. Was it full of receipts from last week’s team retreat? Or was there a paper inside with a photo of a blue baby stapled to it that said, “Needs surgery”? He probably wouldn’t have been offended if I asked. But what did I know about saving lives?

Firefighters, surgeons, sure . . . but people who push paper around?

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