It was in this office that I began to wonder about Dr. Hoda Ghaly. Her name stood equal to his over the office door but she never had patients scheduled. I began to ask careful questions and learned that Dr. Hoda has systemic lupus erythematosus and no longer practices. The first time I saw her was an odd day in Dr. Ghaly’s office. He was wearing a suit.
Dr. Ghaly never, ever, absolutely never-ever, wears a suit. He wears slacks and sport shirts in the summer and slacks and sweaters in the winter—and he does not gradually slide from one season to the other. Dr. Hoda shifts him. One day she gets up and starts clearing out his closet and the next day Dr. Ghaly has changed wardrobes. Once I asked him if he chooses his own clothes.
He looked at me with shock; of course he chooses his own clothes—what do I think he is, a child?
No, I said, do you buy your own clothes?
Well, of course not. His wife buys his clothes. She has very good taste and purchases many attractive shirts and sweaters for him to choose from his closet all by himself.
But this day was different. Dr. Ghaly was wearing a suit. And, at 3:30 in the afternoon, I was his last patient. And then the door opened and in walked two people whom the office staff referred to as Dr. Hoda and son Fadi. Dr. Hoda is a small, compact woman with a significant nose and thick dark hair cut short and waved back from her face. She was followed by Fadi, a slender, dark-haired teenager, who was also wearing a suit. What could this mean? Dr. Ghaly wearing a suit and closing his office early; his wife and son being present, and son also wearing a suit.
When Dr. Ghaly came to see me, I said, “Your son is in trouble and you have to see a lawyer?”
He looked at me speculatively and said, “You are very smart, no?”
Dr. Ghaly speaks somewhat limited American with a French-Arabic accent. In Egypt in the 1950’s, sons of men of position were educated either in British or French schools. He got the French version, however, it is of no consequence because Dr. Ghaly has astoundingly articulate nonverbal communication. His whole body talks. On one occasion, we had a lengthy conversation while he was standing two rooms away from me and was only visible through the doorway.
Dr. Ghaly communicates with a lift of the shoulder, a tilt of the head, a shrug or a gesture. These messages are fine tuned with movements of eyebrows, mouth and other facial muscles. I have never actually seen him wiggle his ears to send a communication, but it wouldn’t surprise me. And, as much as he sends nonverbal messages, so also he receives them. Many times—many times—he has walked past me as he enters his office, then waved me into a treatment room and asked, “What is wrong?” He knows with one glance when a patient is in trouble. Other psychiatrists may question a patient for fifteen minutes and leave without discovering that there is a problem.
But that day, in 1990-whatever, what was wrong was his eldest son, and the story would later be learned: Fadi, well under the legal drinking age, had been stopped by the police while he was driving, and he had an open wine bottle on the seat. If memory serves right, the lawyer got the court charges dropped but certainly the court of his parents opinion would have rendered punishment.
After graduating from high school, Fadi enrolled in the local Catholic college and moved into the dormitory. During the semester, one of his friends dropped dead on the basketball court from a cardiac anomaly. The Doctors Ghaly maintained a 24-hour open house—and open refrigerator—for Fadi and his friends as they guided them through this first, most shocking, encounter with sudden death.
At the end of the semester, for apparently unrelated reasons, Fadi flunked out of college. He was brought home in disgrace, ordered to get a job, and allowed to take night courses at Syracuse University. After a time of this, Dr. Ghaly told me that Fadi wanted to get his own apartment.
“Are you going to let him?” I asked.
“Eh!” said Dr. Ghaly. “Three-point-three [grade point average], he gets apartment. Three-point-oh, he stays home.”
When I related this conversation to Laurie, Dr. Ghaly’s office manager, I noted how clearly Dr. Ghaly set boundaries. Laurie laughed with affectionate derision and said, “Yeah, right! He talks a good line but it’s Hoda who makes it work.” Laurie, a blond, buxom grandmother, was also the children’s babysitter, often staying with them when the Ghaly parents traveled. It was the Doctors Ghaly habit to take one week’s vacation alone together and a second week with the children.
When the children became teenagers and less than enthusiastic about family vacations, Dr. Hoda discovered ocean cruises, which the children enjoyed. Dr. Ghaly claimed never to know where he was going. He worked. He worked all the time. When he was informed that he was taking a vacation, he would advise Laurie—whom he calls Lahtee—of the days to block off his schedule. After his last appointment, he would go home and turn himself over to his wife for further directions.
On the occasion of his fiftieth birthday, she surprised him. One of Dr. Ghaly’s favorite things is gambling, consequently, one of his favorite places is Las Vegas. (He also finds the desert heat very relaxing.) His wife had arranged for Dr. Ghaly’s three brothers to meet him in Las Vegas for a weekend of gambling and brotherly love. Dr. Ghaly came back to work grinning.