The Royal Morgue

People often ask me how is it to work with the members of the Saudi royal family, what are the Princes and Princesses like? To put it short, they are just like any of us, but with some financial and social benefits :)
I wanted to share this interesting incident that once happened to me at work.
The Saudi royal family is huge, estimated to consist of around 15,000-20,000 members. The royals have their own specific services in some of the Saudi hospitals, read more about them here: http://blueabaya.blogspot.com/2010/10/saudi-arabia-and-vip-patients.html

Although they're not designated to accommodate the Saudi royal family, there are the occasional royal patients admitted on the regular wards. Many of them actually request to be assigned a bed on these wards to be under the specific medical service rather than the VIP service, thus getting care more specific to their condition, not status. That and some want to avoid the VIP ward like the plague because of rumors within the extensive royal family. A patient will have many visitors and the other royals will recognize which family it is and there will be talk.

So the incident happened when I was relatively new to the Kingdom and not fully familiar with all the VIP protocols and hassles. It was a regular night shift until the charge nurse received a phone call for an admission from the ICU. I heard her screaming on the phone informing them we didn't have empty beds, then shaking her head in disbelief and putting the phone down. The other Asian nurses gathered at the nursing station starting to speak loudly in Malay and Tagalog. Since I had noticed this was common occurrence I thought nothing of it.

After a while the admission was to arrive and I saw some nurses getting a room ready. They had transferred one patient onto another ward to empty the room. I was busy with my own patients and because I was not the nurse allocated to receive the new patient, continued to ignore the racket the Asian nurses were causing over the transfer. I was the only western nurse on duty and they usually didn't bother to tell me what was going on so I thought it was insignificant.

When the patient finally arrived from the ICU on her bed suddenly all the other nurses, including the charge and the allocated nurse suddenly disappeared like samboosas on Ramadan. I saw the western ICU nurse pushing the bed with some five male relatives. The patient was totally covered with a white sheet, which is normal in Saudi for the female patients. When they get transferred on their beds around the hospital, for privacy reasons they pull the white sheets on top of the whole patient resulting in a going to the morgue-look.

So as the only nurse around I received them with a friendly greeting and directed them to the room. Next we had to transfer the patient to the ward bed. We turned the patient and placed the sliding board underneath pulling her to the other bed. I thought it was odd they still hadn't wanted to remove the covers, but had gotten accustomed to seeing all sorts of things and again thought nothing of it. I took notice of the pristine white crisp thobes and strong perfumes the men were wearing and assumed they were of upper class status.

Next the male relatives started to fuss about the A/C. The most common immediate complaint the patients have when they come to the rooms is the air conditioning is too COLD. Saudis are afraid the cold air will worsen all illnesses. So I assured them I would adjust it to make it at hot as possible. The looks on their faces were as if I'd said something to the likes of " I will give the patient heroine".

The oldest one replied now clearly upset in English, "no we want cold! And bring ice! We need lots of ice." I informed them of the ice machine we had in the patient kitchen which they could use freely. The men looked at each other and I got a feeling they weren't liking my services so I excused myself and left the room.

I had the patients file now in my hands but did not have time to look at her details, rather I wanted to find the allocated nurse to hand over the file to but she was nowhere to be found. Next a myriad of black clad women started entering the ward. They were all dressed in designer abayas, wearing high heels and had covered their whole heads with the ends of their shaylas (scarves) thrown over the faces. The smell of expensive bohkoor and perfumes filled the ward. I felt a sense of curiosity now and checked the patient name. Al-Saud. And the two names before that made me gulp.

Now it started to make sense why all the Asian nurses had vanished and were still hiding in the patient rooms. I was still the sole nurse visible on the ward, standing like a statue now at the nursing station not knowing what to do. The female relatives asked for the room number and inquired what would happen. Some were weeping frantically and waving their hands in the air chanting something I assumed were prayers. Others were being walked by two Ethiopian maids on each side. One needed a wheelchair. I had seen all the drama Saudi women could create but nothing to this scale before.

Finally the frightened charge nurse emerged from her hiding place. I asked her what was going on and the whole insane truth was revealed. The patient was indeed a royal Princess. As a matter of fact, she was also deceased. They had just admitted a dead body. I had unknowingly been transferring a deceased royal Princess. I gasped at the thought of not only handling a dead body like one that was alive and thought back at everything I had told the relatives. Why didn't the nurses inform me? It seemed I was the last to know again.

Naturally in Saudi like all other hospitals around the world, the deceased patient will be washed and prepared and then transferred to the morgue. According to Islam the body should be buried as soon as possible and any decaying of the body should be avoided. The process in Saudi is very swift compared to what we are used to in the west, where the bodies might be in the morgues weeks at a time for example. Very seldom are autopsies carried out in Saudi-Arabia. Once the patient dies, the families take it as a decree from Allah and the reason of death to them becomes insignificant, unless they suspect a gross violation from medical staff which is extremely rare (that they would suspect or care).

So why was the dead body of a royal Princess occupying one the beds on our ward, not the morgue, or the VIP ward which has huge rooms complete with separate guest rooms? Well the reason is simply that is what the family wanted and because of their status, they could make it happen. They wanted for all the relatives and especially the King to be able to say goodbye to her before she was taken away, and the morgue would not be a place fit for a Princess as high as her. How could the royal relatives visit the morgue anyway?

So ice was brought in by the truckloads, the AC was adjusted, gigantic flower arrangements and golden chairs fit for Princesses to sit on were brought in from the VIP ward and when there was no space left inside the room, the hallway leading to the room was lined with them. Expensive bokhoor was burned in the room (it is forbidden normally) and the "royal morgue" was up and running.
Relatives kept coming in and out causing quite a lot of confusion in the other patients. There was hysterical crying in the hallways, maids coming in with trays of chocolates, pastries and other foods serving Arabic coffee from the intricate golden dallahs, drivers and guards were hanging around the hallways.

One of the younger princesses couldn't handle the stress and Her Highness was brought to me to measure her blood pressure. I took the moaning and groaning princess to sit in a quiet area and took the readings. They were slightly elevated but nothing to worry about, I said. The male relative strongly disagreed and demanded to see a cardiologist at once. He ordered me to give blood pressure medication on the spot.

I tried to explain to him how first of all since the woman was young and not on any medications I could not just go and get a blood pressure medication randomly, and second there are maybe hundreds of medications and doses to choose from and third, I could not even get it out of the machine without a doctors orders and her being listed as a patient on this ward, and fourth no doctor would even prescribe to her any medication based on these readings. I told him it's best we let her sit for a while and drink some water and try to relax, she will be just fine. He was clearly upset at what I had suggested and acted as if the woman was going to have a heart attack.

But as is common with demanding Saudi patients my explanations were not good enough and so I was forced to call the cardiologist who in turn had to come from the cardiac surgery unit down to the floor. He was extremely angry at me for calling him, even if for a royal princess. When he saw the readings which were by now even better, he simply laughed and left. The male relative (could've been her husband, brother, father or grandfather you never know here) was upset at the lack of service and took the faint princess elsewhere. I was relieved.

It was now nearing Fajr prayer time and the worst traffic to the newly established morgue had quieted down. The Asian staff were all mostly hiding in the staff room or patients rooms, trying to avoid any contact with the royal family in fear of saying or doing something to upset anyone and as a consequence, loosing their jobs.

There was still no word when the King would make his appearance to say his farewells. There were guards placed on all the entrances and all of the staff was anxiously awaiting his arrival. I was actually excited to have the opportunity to at least see him.

By the time night shift was over the ward had started to have a distinct deathly smell to it. Especially around the room turned morgue the stench was getting almost unbearable despite all the bokhoor and flowers. To my diappoinment I never got the chance to meet the King.
Eventually the King had arrived for a quick visit that afternoon and only after that was the body taken to the cemetery for burial.

This is one of the stories from the hospital I will never forget. And it could only happen in the Magic Kingdom!