Bitter Pills: Islamist Extremism at the Bedside

LONDON—Afternoon dissolves into evening. I peer out of my office in the Royal London Hospital, spying the window that once framed the Elephant Man. A century later, a new and equally grotesque spectacle enthralls—in the street below, a well-fed British-Pakistani distributes cassettes. Transplanted Wahabi women, black-gloved, clad head-to-toe in black abbayas, faces masked by niqabs, snatch the recordings, nodding brief salaams. Other women, too busy, rush by in damp, rain-streaked chadors. I watch the figures until they disappear into the dank Whitechapel tube station. Muslim men stuff the cassettes into their grubby Adidas jackets, worn over thobes, the traditional Arab male dress. Only a sprinkling of stolid British police officers reminds me that, under the lapping October tides of Western European Islamofascism, this is still London.

The man thrusts his homemade compilations at passersby. A thobe ending above his ankles— its length identical to those worn by Saudi Arabia's muttawah, or religious police—marks his fundamentalism. He mounts a makeshift podium atop a monument donated to Whitechapel by Jews who had thrived here 90 years earlier. What British Jews once dignified, British Muslims now desecrate. "Death to America! Death to Israel!" he shouts.

His working-class Geordie dialect is flawless. Leaning into the headwind, he intersperses his sedition with the plea known to every Muslim as the Takbir: Allah-hu-Akbar! God is Great. Anchored to his pulpit of hate by Nike high tops, his fat fists punch a canopy of defiance overhead. Constables eye him, unperturbed. They have heard his rant before. Uncertain clusters of British Muslims are ensnared in his devious orbit.

Fundamentalism in Scrubs

Abandoning the scene, I hurry. I am needed. While reviewing X-rays, I test the resident. Faisal is a young anesthesiologist and a caring, gentle physician. He is dressed in operating room greens. To the informed eye, they reveal a cultivated Islamic identity: his scrub pants are a deliberate fraction too short, ending just above his surgical clogs, the still-damp hems testament to his recent ablutions. Faisal's straggling beard is left untrimmed, and rimless Cartier glasses frame long-lashed eyes. I squeeze some rub from the dispenser, cleaning my hands en route to the bedside. I prompt him to do the same.

"No thank you, Dr. Ahmed. I will wash my hands," he declares, moving to the sink. Puzzled, I explain the recommendations on hand hygiene—alcohol hand rub is preferable to soap—for more effective infection control. Perhaps he is not aware of the new guidelines?

A vacant stare meets mine.

"Oh no, Dr. Ahmed, you don't follow. I am Muslim." A flicker of superiority flashes across his flat gaze. I suddenly realize that Faisal has failed to recognize the Muslim in me.

"It is haram for me to touch alcohol," he says. "I can't use alcohol hand rub on my skin." There will be no negotiation. What I have suggested, he is saying, is banned by shariah, Muslim holy law.

I am agog. Faisal's is a radical interpretation of Islam—one which I had not encountered, even among Saudi physicians who were active members of Riyadh's clergy. How had Faisal acquired these beliefs?

I search for explanation in his origins. Like me, he is British by birth, of Pakistani heritage. With an amalgam of nostalgia and pride, he describes an early upbringing in Jeddah, Saudi Arabia. Later, Faisal graduated from St. Bartholomew's, one of the oldest, most distinguished medical colleges in England. A marriage to a pre-selected Pakistani woman, now secluded in his East London home, quickly followed.

The Lancet

Some months later, I mention the hand washing incident to Saudi friends at a symposium in Riyadh. They too have encountered similar reports, including at the World Health Organization. Eventually, we publish our findings in The Lancet, Britain's leading medical journal. Faisal, it seems, is far from isolated in his beliefs.

Rejecting alcohol-containing agents on the basis of Islam is increasingly common, and has already triggered research for alternatives. Surprisingly, this refusal seems to be centered in the...