The Pathological Optimist: One Man's Vision for Palestinian Well-Being

“You know, this man is really remarkable,” Anant told me,

“but one day no one will know of him. His goodness will have

consequences, of course, but unless you write about him, the

specifics of his life and his attitude may not be preserved.”

—John Berger, A Fortunate Man

 

DR. EYAD EL SARRAJ died from leukemia in December 2013. He was seventy years old and lived a life of service. The Gaza Strip defined his identity and framed the focal point of his work. It was where he grew up, where he always returned, and where he made his mark. He assumed many roles, all of them designed to protect people from cruelty, fear, and humiliation. He was Gaza’s first psychiatrist and a pioneer in the practice of community mental health. He insisted that wellbeing was impossible without peace and justice and founded a program that integrated clinical services and political advocacy. He was a prolific commentator and masterful storyteller who brought the intimate, day-to-day ordeal of occupation to a global audience. A relentless critic of Zionism and what he saw as its aggressive paranoia, he forged enduring ties to Israeli activists and never stopped believing in the ideal of binational coexistence. He served as commissioner general of the Palestinian Independent Commission for Citizens’ Rights, which sought to protect against abuse by governmental authorities, whether Fatah or Hamas. He wanted to bring the world to Gaza and Gaza to the world, and played host and guide to generations of visiting diplomats, foreign correspondents, academic researchers, and solidarity campaigners.

 

He was a secular intellectual and urbane cosmopolitan who traveled widely and was educated abroad. But away from Gaza, he felt exiled and bereft. His fierce attachment, which he described as an “addiction,” had deep roots in his childhood. Even when war and siege had ravaged this tiny Mediterranean enclave and pushed its nearly two million residents to the brink of survival, even when beaches were fouled with raw sewage because of bombed treatment plants, and candles had replaced electric lights because the power grid was smashed, even when fratricidal violence erupted between rival Palestinian factions and prospects for a coherent national project never looked so bleak, Eyad kept in his mind’s eye an Edenic past: a glorious time of a close-knit family and mother who adored him, a pristine landscape, a diverse and vibrant community. These trace memories of bliss provided an enduring source of psychic nourishment, helping to sustain an indomitable spirit of hope, or what he called, with self-deprecating irony, “my pathological optimism.”

 

There were gaps between the reality of his actual childhood experience and the idyllic vision he would later conjure up. Dispossession and violence intruded on his lost paradise. He was born in Beersheba where his father, originally from Gaza, had moved to become an administrator with the British Mandate. The 1948 war changed everything. “I was only five years old at the time, but I remember that day,” he later told an interviewer. “I remember my mother pushing our sewing machine into the waiting truck; and my father, with a dismissive wave of his hand, indicating that she best leave the machine. Years later, I had learned that he was certain we would be home again in two weeks. Because of what she left behind, my mother was sad for years.” [1]

 

They came back to Gaza not as destitute strangers but as returning natives with a vast network of relatives who comprised part of the local elite. The family soon settled into a spacious house; the father found a job with the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), which had been set up on a temporary basis to deliver short-term humanitarian assistance to Palestinian refugees, pending their expected repatriation. But this never happened. Israel remained adamantly opposed, and United Nations General Assembly Resolution 194, which resolved “that the refugees wishing to return to their homes and live at peace with their neighbors should be permitted to do so at the earliest practicable date,” went unenforced. The sudden influx of two hundred thousand desperate arrivals transformed the character of Gaza, whose pre-1948 population was estimated at between sixty and eighty thousand. [2] Fault lines quickly developed between original residents, with land, money and social status, and evicted and impoverished newcomers. Though his own family provided Eyad with a life of comfort and privilege, the larger community in which he came of age was grief-stricken. Refugees crossed the armistice line to retrieve possessions or to conduct guerrilla raids. Israel responded with reprisal operations, including a 1953 attack led by Ariel Sharon and his Unit 101 against al-Bureij refugee camp that left fifty dead and many more wounded. Eyad’s first direct encounter with colonial violence dates back to early November 1956 when he looked out of his window one morning and saw the street littered with corpses. The Israelis had launched Operation Kadesh, a plan to annex the Sinai Peninsula and two Red Sea islands, thus restoring after fourteen hundred years what David Ben-Gurion and Moshe Dayan regarded as the divine territorial dominion of the Hebrew Kingdom. Soldiers broke into the family house; one of them pressed a rifle into the small of his back and marched him down to the cellar. “I was so afraid, I wet my pants.” [3]

 

In high school, he was an excellent student, though dreamy and without plans for the future. He thought vaguely about becoming an artist because he enjoyed toying with ideas, or a farmer since he wanted to tend to the earth and make it flourish. His mother, however, had more conventional ambitions for her favorite child. He would pursue medicine, which among Palestinians represented the profession of greatest prestige. Dutiful, he left for Alexandria University to begin his course work. He found the curriculum boring. Professors demanded rote memorization. There was no space for imaginative inquiry, and no discussion of medicine as a social and ethical pursuit. He began to spend less time in the library than in walking along the Corniche from the Citadel of Qaitbay to Montazah, or sitting in crowded cafes with a multinational mix of friends. There, they spoke about the shining example of Gamal Abdel Nasser and the rise of the pan-Arab movement; the nature of socialism and whether its principles might be applied to the region; and always of course, the struggle to liberate Palestine from Zionism, and how it could be waged most effectively.

 

But an event occurred that triggered a rededicated commitment to his training. “My roommate, a brilliant, physically awkward, and deeply eccentric medical student who studied by flashlight under his bed, fell into depression and stabbed himself in the heart. His death was shocking. It made me want to learn how I could make life more bearable so that others might be spared the choice made by my friend.” [4] His interest in psychiatry grew. A faculty adviser helped arrange a placement for Eyad at Cairo’s Abbasiya Mental Hospital and Asylum, a vast complex and the largest institution of its kind in the Middle East. It was a searing experience, exposing him to a nether world of carceral control in which one group—doctors and nurses—demeaned and degraded a captive population: “Patients crying out for sympathy and attention were kept in crowded rooms with bad food thrown at them like dogs. Staff acted like robots.” [5] He observed that in such a structure of domination, the custodians themselves, not just those held in custody, become stripped of humanity.

 

In 1970, he completed his medical degree and went home to Gaza, where he joined the staff of the pediatric clinic at al-Shifa Hospital. Immediately, he was summoned by the local head of Israeli intelligence. Forced to retreat in 1956 following an ultimatum from U.S. president Dwight Eisenhower, the military occupiers were now back and firmly ensconced. Gaza, along with the West Bank, had become spoils of the 1967 war. The intelligence officer wanted information on Arab student activists. When Eyad refused, he was ordered to return the following day with a written dossier. He never came, and for such recalcitrance was fired from his job. Far from being intimidated, Eyad responded with furious outrage. He denounced Israeli efforts to convert even hospitals into recruiting grounds for spies. He rallied other doctors at the hospital to go out on strike. He wrote letters of protest to the president of Israel and members of the Knesset, and contacted the World Health Organization (WHO). The storm of publicity drew unwanted attention to Israel’s expanding apparatus of colonial control. Fearing further exposure, authorities allowed Eyad’s reinstatement. He was never again approached to collaborate. Pride, social status and professional influence, and an instinct to speak out and fight back, all combined to make him too hard a target.

 

Eyad enjoyed working with children. He had an affinity for their humor, emotional honesty, and natural rebelliousness. But mental health continued to be his driving professional interest, and in 1972 he took a position at a psychiatric hospital in Bethlehem. There were 350 patients, many long-term, and many suffering from psychosis and schizophrenia. While conditions were less brutal than at Abbasiya, treatment still remained inadequate, with electric shock widely prescribed. Frustrated by what he saw, Eyad looked to acquire a broader repertoire of skills and experience. A year later, he won a WHO scholarship to train in psychiatry at London’s Maudsley Hospital. He remained in England for five years, three at Maudsley, and two at Barnet Hospital in north London. He thrived in his new environment. He read deeply, studied with professors who encouraged independent thinking, and received clinical supervision from outstanding therapists. His sojourn coincided with a period of ferment in psychiatric theory and practice. A pivotal figure was Franco Basaglia, an Italian neurologist based in Trieste who led a movement to deinstitutionalize large asylums and reintegrate patients back to the community. His 1968 book, L’istituzione negata (The Denied Institution), describes patients and staff tearing out bars from grated windows and writing on cell walls the slogan of their emancipatory project: “Freedom is therapeutic.” [6] Eyad was attracted to Basaglia as a fellow iconoclast and drew from his ideas. “At Barnet, we set up an experimental treatment model organized around principles of the therapeutic community. We reached out to families and explained to them the role they played as part of an overall system of support. We gave patients opportunities to help design their program of rehabilitation so they could regain a sense of social competence and self-worth. My time at Barnet helped form the bedrock philosophy of my later work in Gaza: the restoration of dignity and respect remains the most powerful active element in helping human beings to function fully.” [7]

 

Full of plans to apply and adapt what he had learned, he arrived home in 1978 as the Gaza Strip’s first and only specialist psychiatrist. Opposition soon emerged, but this time not from Israeli security officials. Members of the Palestinian medical elite felt threatened by the presence of a brash foreign-educated reformer and closed ranks to thwart his attempts to establish a residential program. Finally, after months of doing battle, he opened a small mental health unit. There were sixteen beds, ample grounds, and a handful of committed staff. Families became involved as a vital part of treatment. Mothers, brothers, and sisters participated in daily activities and even stayed overnight to look after their relative. Time spent as informal helpers increased their confidence and competence to care for the patient on discharge. Staff worked with and through families, breaking down barriers of status to create a collaborative alliance. The partnership also facilitated a transfer of knowledge about mental illness. The unit operated as a classroom to raise consciousness, reduce stigma, and demystify behavior that many Gazans ascribed to satanic possession. Eyad devoted the next seven years to refining his model. Patients were successfully treated and reintegrated. And bit by bit the community became more aware of the nature of psychological disorder and more prepared to seek out assistance.

 

On 8 December 1987, an Israeli army tank transporter smashed into a line of cars full of Gazan workers returning from Israel. Four died, three of them from Jabaliya, the largest of the Strip’s eight refugee camps. Following the funerals, thousands of camp residents demonstrated against the killings. Israeli soldiers fired on the crowd, igniting a mass movement that would emerge first in Gaza and then spread to the West Bank, continue for years, and transform Palestinian politics and society. The uprising, or intifada, relied on unarmed resistance and civil disobedience. A broad coalition of factions joined together to organize general strikes and an economic boycott. Citizens refused to pay taxes, buy Israeli products, or take jobs in settlements. Israel reacted with an “Iron Fist” policy, one that included targeted assassinations, house demolitions, mass arrests, imprisonment and torture, and round-the-clock curfews. Soldiers were given truncheons and encouraged to break bones of protesters. Young people bore the brunt. Between 1988 and 1990, up to thirty thousand children received beatings severe enough to require medical care; one-third were under the age of ten.

 

Eyad felt compelled to respond; in early 1988, he began to put in shifts as a casualty doctor at al- Shifa Hospital. He treated the wounded, received the bodies of the dead, and comforted relatives. From his intimate engagement with the popular revolt, he saw much to be admired: unbending discipline, solidarity instead of sectarianism, and great bravery and a spirit of sacrifice. But he remained alert to the toxic sequelae of violence. Though boys fighting tanks with stones were being elevated to the status of national hero and redeemer, he knew such iconic images of defiance concealed the reality of children’s experience. To grow up in a war zone meant repeated exposure to traumatic events that would imprint deep feelings of loss, insecurity, and sadness. Eyad was also prescient that violence would infect not just the victim but the perpetrator as well. He forecast that military aggression would brutalize Israeli society and make conflict more intractable.

 

At al-Shifa, Eyad played host to eleven Israeli physicians who had come to see for themselves the situation on the ground. Ruchama Marton, who was part of the delegation, describes the scene: “Gaza, January 1988: it is very cold. The streets are deserted. Streets which are passages of mud and rainwater mixed with sewage. There is no efficient drainage. Young people, lips blue from the cold, allow our van to pass despite the general strike declared in Gaza. A total strike: all the stores are closed and no cars are on the road. The van arrives. It is very cold in the hospital as well. It is packed. All the beds are filled with young people injured from beatings or shooting by the army’s soldiers. There we met Dr. Eyad al-Sarraj. He was a tall man with curly hair and a charming smile. He escorted us, explaining in a soft voice the harsh sight of the wounded young people, and the governmental hospital Shifa’s neglect and filth.” [8]

 

When the day ended, Eyad invited members of the contingent to his home. They arrived, shaken by their experience. Conditions at al-Shifa were worse than they had imagined, a world away from their own modern and well-stocked places of practice. The injuries they saw had been inflicted by the soldiers representing the country to which the doctors belonged. At the beginning of the evening some of the group were aggressively sullen as a defense against feelings of shame and embarrassment. But Eyad’s gentle manner soon put them at ease. He thanked everyone for traveling to Gaza, telling them how important they were as witnesses and as voices for peace. “He had a gift for creating rapport with people and building trust,” Marton said. [9] On this occasion, he used it to full effect. He and his visitors were soon exploring a joint project. The conceptual groundwork was laid for Palestinian-Israeli Physicians for Human Rights.

 

Along with Eyad, Marton emerged as the moving force behind this solidarity organization. Anti-Zionist, radical peace activist, practicing psychotherapist, and pioneering feminist, she became Eyad’s lifelong friend and colleague. In years to come, they would travel the world as a speaking team. During a conference in Canada, a woman in the audience rose to denounce Marton as a traitor for sitting on the same stage with the Palestinian enemy. Marton responded with a personal narrative. In 1956, when Eyad, then a twelve-year-old boy, was being forced into a cellar with an Israeli gun at his back, she was a nineteen-year-old Israel Defense Forces (IDF) conscript stationed with the Givati Brigade in the Sinai desert. A group of thirty or so surrendering Egyptian soldiers approached their position. Exhausted, thirsty, and hungry, they begged for food and water. An Israeli officer ordered their execution; the men were shot. The massacre changed her forever. She had seen what “purity of arms” meant in action, and never again could turn a blind eye to crimes of the state or to the complicity of her fellow citizens. “That’s why I am here tonight with Eyad,” she said. “Maybe I don’t live at peace with my society, but I can almost be at peace with myself.” [10]

 

Shortly after her initial visit to Gaza, she received a phone call from a high-ranking Israeli security officer. He wanted to see her, and she agreed to meet at a cafe in Tel Aviv. “What do you know about Dr. Eyad Sarraj?” he asked as soon as they sat down. “What do you know?” she responded. “I want to warn you for your own good: he has lots of Israeli women.” She got up immediately and walked out, leaving him to pay the bill. The next day, Eyad was arrested by Israeli authorities and effectively deported. “We do not like you any more than you like us,” an officer told him. “Please leave Gaza and do not come back,” handing him travel documents that he had applied for months earlier but which up until then had been rejected. [11]

 

He would be gone for two years but never stopped thinking of home. He took up residence at the Oxford University’s Refugee Studies Centre, invited there by its founder, anthropologist Barbara Harrell-Bond. From this base, he began to imagine an ambitious project that would integrate clinical treatment for the most vulnerable groups (especially children and youth), outreach and education to support families and strengthen communal cohesion, and research and documentation to record the human toll inflicted on Gaza and to generate international pressure for change. During his time abroad, Eyad traveled widely to solicit comments and advice and to seek out donors prepared to support his venture. Finally, in 1990, he returned to Gaza, successfully challenging Israeli authorities who dropped their ban rather than risk what they feared might become a high-profile public confrontation.

 

The ideas and insights Eyad brought back gave rise to the Gaza Community Mental Health Programme (GCMHP). Starting on a shoestring with three volunteers and space donated by a relative, it went on to become the Strip’s preeminent nongovernmental organization with a hundred and twenty staff implementing a broad agenda. The program eventually comprised four neighborhood-based clinical centers, an academic degree course in mental health and human rights, a women’s initiative that provided jobs and counseling support to victims of domestic abuse, a crisis intervention phone line, and a training unit to help schoolteachers understand childhood trauma and its effect on educational development. A hub for global exchange, GCMHP convened a series of conferences that brought a steady stream of foreign scholars, journalists, health-care professionals and political activists, many of whom would remain lifelong advocates for Gaza and for GCMHP. The program also sponsored visits by international researchers whose fieldwork helped document the social and psychological toll of Israeli violence. None of this complex architecture of direct service delivery, education and training, and outreach and advocacy existed before. It came into being as the result of Eyad’s single-minded effort, one to which he brought will, knowledge, and imagination, along with great personal charm and attractiveness. Donors who visited Gaza saw him as one of a kind. He was a worldly sophisticate, a graceful host, and a gifted raconteur. He spoke perfect English and possessed impeccable professional credentials. They flocked to him. Funds poured in and the program grew exponentially.

 

For the young staff who joined GCMHP during the early years, Eyad was a mesmerizing leader who drew them into his magic circle and made them feel singled out for service on a noble mission. A deep sense of common purpose took hold. The program became a hive of shared activity; barriers of status gave way to democratic egalitarianism. Eyad ate with his staff, spoke to them as valued colleagues no matter their age, discussed ideas, and welcomed debate and dissent. He trained young psychologists by having them observe his clinical interviews, and then writing up case notes, which he then would edit, amending some aspects, but always explaining why. He led through example and embodied the principles he sought to instill. “He used to say to us, ‘Work, work, work. Heal yourself with work, kill yourself with work,’ remembers Hasan Ziada, who was hired by Eyad in 1991. “Work for Eyad represented a form of therapy. It made him feel productive and alive.” [12] He arrived at the program early in the morning and often spent the night. There was no distinction between his public and private life. He had a compulsion to do something good for Gaza. It was driven by a reaction to suffering so viscerally powerful that it seemed galvanic. A staff member recalls a woman who approached Eyad and told him she had no food to feed her children. “It was as if he had been touched by an electric shock. He pulled out his wallet and gave her everything. He took mine and emptied it too.”

 

Husam al-Nono joined the program in 1993 and continues today as one of its senior managers. He recalls Eyad’s pedagogical style. “He analyzes you; tells you about yourself; tells you what you can become and what you need to improve. He made us feel that he needed us, that he was interested in our inner lives, in our hopes. He always used to tell us, ‘I like what you do; I like how you think.’ He looked for the good in people. He gave without ever keeping account of favors done. He gained through seeing others become more capable, more thriving. He fed off of their happiness. He wanted the world to be bountiful; he wanted everyone to share in it; he wanted to be the host who set the table for the world.

 

“He encouraged us to go deep into the psychology of things, to understand what motivated people. He approached his patients as if they had something to teach him. He was hungry to learn; and he could learn from everyone, educated or uneducated—it made no difference. He was prepared to be a student as well as a teacher; he allowed himself to say, ‘I don’t know.’ He made his points through telling stories. His language was charming, poetic, full of metaphors. He was magic with words and could cast a spell. In traditional Arab villages, men used to gather at night around the fire to listen to stories, sometimes accompanied by a musician. Eyad came from this tradition. The stories he told were amazing and often shocking. He told us what had happened to him, what he saw and heard during his travels to different parts of the world, during his meetings with people in power and people who had nothing. These experiences helped shape his vision for how Gaza needed to change. He shared this vision with us and made us feel that he was recruiting us to a great cause, that we had a purpose in life, a destiny in life, that we needed to fulfill.” [13]

 

Fundamental to Eyad’s vision was a new mode of collective resistance, one that took full account of the adversary’s arsenal and plan of attack. Israel’s most crude weapon was brute force—breaking bones with truncheons, assassinating key figures, jailing and torturing tens of thousands of prisoners. But there were other forms of violence more subtle and insidious. Like Fanon, Eyad understood that the colonial project sought not just to annex and occupy land but also to infiltrate and control psychological space. By itself, military power would never be enough to defeat a popular movement. That could only happen if Palestinians lost their bearings and began to see themselves through the eyes of the oppressor: demeaned, cowering, contemptible.

 

“I remember a home visit I once made to a family I was treating,” Eyad said. “The mother pointed to her one-year-old baby and said, ‘I would send him to die as a martyr’; then she looked at her husband and said, ‘not like him, dying in fear and with no dignity.’ Do you know what it means to feel that you are the slave of your enemy—building their homes on the remains of our villagers? Do you know what it means for a child to see his father spat upon and beaten by an Israeli soldier?” [14]

 

Eyad put GCMHP at the forefront of the struggle pitting humiliation and contempt against dignity and self-respect. Everything that the program did aimed to build resilience. This was often less a matter of binding wounds—though individual patients were seen for clinical treatment—than of promoting citizenship and social solidarity. What Eyad taught his staff became converted into an organizational credo: caring for each other, we find meaning and make ourselves strong. The program worked with parents, teachers, and other public guardians to help them understand the inner lives of children, the wounds that exposure to violence can inflict, and the healing properties of emotional support from families and community. Joining together to protect the young represented an active expression of moral cohesion and civic responsibility, and therefore an antidote to hopelessness and helplessness. “We always felt that, as Gazans, our biggest asset, our treasure, our power, was our social fabric,” said Ziada. “If it is torn irreparably, we are gone. It always needed to be repaired, and that is what we tried to do.” [15]

 

Eyad was quick to denounce Oslo as a fraud, a betrayal, and a threat to the communal cohesion. The accords provided security for the occupier while doing nothing to ensure democratic rights for Palestinians. The return to Gaza of Yasir Arafat and his venal entourage unleashed a frenzy of corruption and a clampdown on dissent.

 

Power became embodied in the single figure of an authoritarian patriarch who ruled through largesse. Eyad had ample opportunity to receive favor and acquire benefits. His sister was a close friend of Arafat’s wife, Suha; his brother-in-law ran Arafat’s financial empire; during a face-to-face meeting in 1965, Arafat had tried to recruit Eyad into the Palestine Liberation Organization, and even afterward, the courtship continued. Despite this history, Eyad became an outspoken critic. Repeated threats did nothing to silence him. He was arrested, jailed, and beaten. “One day during my last detention I overheard a Palestinian officer interrogating a Palestinian man,” Eyad said. “He was calmly asking questions, but there were no answers. Gradually, the interrogator’s voice rose to a shout. Suddenly, he was screaming: but in Hebrew. I was stunned. That was a graphic illustration of the powerful psychological process of identification with the aggressor. In simple terms, the Palestinian officer who was once a helpless victim in Israeli prison was now assuming the position of power, which in his deepest mind was symbolized by the Israeli officer.” [16] Eyad saw such unconscious complicity as the most dangerous kind of collaboration, far more damaging than any number of spies that the Shin Bet was able to recruit. For Eyad, weakness and vulnerability and neediness were intrinsic; to root them out, as the interrogator had attempted, was root out what it meant to be human. Children of the stone were made of flesh and blood. At school, they had trouble concentrating; in their beds at night, they had disordered sleep. Welcomed back as conquering heroes, symbols of sacrifice and steadfastness, ex-prisoners returned home with wounds they had to hide and sometimes with compulsions they were unable to control. Eyad worked relentlessly to raise public awareness of the damage inflicted by violence and to help victims regain a sense of dignity. He explained that mental health symptoms were often connected to the struggle for a national cause, and therefore should be seen as battle scars.

 

In Eyad’s long career as pioneer and iconoclast, one of his most daring decisions was to forge and maintain an alliance with Israeli peace and human rights activists. When GCMHP first began, Eyad invited Marton and a team of her associates to provide training. Every week, they drove to Gaza. Later, Eyad worked closely with Felicia Langer, a left-wing lawyer representing Palestinian clients and the Public Committee Against Torture in Israel. Even during periods of intense conflict when many in Gaza regarded any contact with Israelis as at best normalization, and at worst collaboration, Eyad refused to sever his ties. He stood his ground not only because of personal allegiance to his friends, but also because he believed that cross-border networks represented a lifeline that kept alive a shared vision of coexistence based on a just peace.

 

He continued to denounce Israeli state policy in acerbic newspaper articles and furious letters sent to leading representatives of the so-called international community. In “Doomed,” an October 2000 opinion piece published during the al-Aqsa confrontation, he concluded with a warning and a plea: “Israel is sick, terrified of peace, terrified to look in the mirror, terrified of recognizing the monster within. Unless it looks inside itself, Israel is doomed.” [17] In May 2002, he wrote U.S. secretary of state Colin Powell: “Certainly, Palestinian terrorism has also to do with the failure of the Palestinian Authority to implement at any early stage the rules of law, order and democracy in the area under its jurisdiction, as this might be interpreted as a submission to Israeli diktat and giving up the pursuit of an independent Palestinian state. However, first of all Palestinian terrorism and extremism find their roots in feelings of despair and humiliation caused by the longstanding occupation, the accompanying encroachment on elementary civil rights, and the severe disillusionment with the Oslo peace process.” [18]

 

It was his fervor for peace that made him unwilling to abandon hope that a saving remnant still survived in Israel. “We must win the battle in Tel Aviv—win the battle for people’s hearts,” al-Nono recalled him saying. “All our weapons should be collected and deposited at the Erez checkpoint.” Few in Gaza followed his call. “It is very hard to get victims of killings and tortures and executions and abuse to accept nonviolence,” al-Nono observed. “They live in agony. But Eyad said that you don’t go into the ring with a professional boxer: he will beat you up. Beat him at chess. Create a moral battleground where you have the advantage. Eyad used to repeat that all of us are human: we, the Palestinians; they, the Israelis: unless you are crazy or blind, you must accept this, and then work hard to find a way to share life together.” [19]

 

In 2004, Eyad traveled with Mahmoud Daher to Tel Aviv for an event organized by Physicians for Human Rights. The theme was access to health care for Palestinians. “We crossed through the checkpoint at Erez,” recalls a colleague who was traveling with him. “We went through a VIP lane. It was manned by a young soldier, an ultra-Orthodox, maybe nineteen or twenty years old. He seemed like some settler from Hebron. He spoke to Eyad in a rude and aggressive voice: ‘Who are you? What are you doing?’ ‘I am a psychiatrist,’ he replied, calmly and gently. The soldier seemed surprised. ‘That’s an important job,’ he told Eyad. ‘Both of us need a psychiatrist,’ Eyad said. ‘Every president, every prime minister needs a psychiatrist.’” Through humor, through charm, through self-control, Eyad was able to disarm the soldier and to engage him in a conversation. Eyad saw him as a frightened boy whose fear needed to be contained. He had an instinct and talent for deescalating potential conflict by opening himself to others. Eyad arrived at the event and got up to speak. “I have a text prepared, with lots of statistics and figures,” he said. “But I am throwing it away. I want to speak to you directly. I am a Palestinian from Gaza. I don’t want to draw a rosy picture. No, there are huge differences that separate us. But what we face, what both people face, is a common set of challenges. Unless we meet these challenges together, we both are doomed.” He spoke with great sincerity and simplicity. The audience responded to his humanity. They believed him and saw him as an ally.

 

Though Israel’s aggressive hysteria appalled him, he understood its origins. While he despised the ways in which the Holocaust was politically deployed and instrumentalized to sacralize Zionism and confer on it immunity and impunity, he never denied the immense extent of Jewish suffering. Part of the psychic legacy, he believed, was hypervigilance and a hair-trigger readiness to lash out against any imagined threat. Obsessive dread, animated by a deep sense of vulnerability, made Israel dangerous to itself and others. Treating such a condition required great care. Eyad drew on a story from his own practice to suggest key principles. “One day I was going to my clinic in downtown Gaza. There was a big crowd in the middle of the street. I could not keep driving so I parked the car and walked the rest of the way. There were so many people blocking the street, shouting and screaming. I moved through the people and it turned out they were circling around one man who had a sword and was waving it about in huge sweeping circles. Everybody was frightened, but they wanted to reach him. The man was frightened more than anyone. He was defiant but deeply frightened. And he was one of my patients. I recognized him. And I sensed that they were going to kill him. Suddenly, if he lost control, they were going to jump on him and he would be beaten to death. So I worked my way through the crowd until I came face to face with him. I called him by his first name and I said, ‘Ahmed!’ And he said, ‘Dr. Eyad!’ He came and jumped on me and threw down the sword. And then I walked out with him. I risked something. But he would not have talked to just anybody. I called him by his name and then I opened my arms. He still had the sword, right? He could have killed me. What does this story teach? First, that we have to be willing to take risks if we want to disarm fear. Second, that our approach must be gentle but deliberate. And third, we have to understand that panic is painful, and that if given a chance, most people, even those suffering from a mental disorder, will choose to surrender their fear.” [20]

 

In 2005, a year after Eyad addressed the audience in Tel Aviv, the Sharon government evacuated Jewish settlements from Gaza and withdrew IDF troops. Hamas celebrated the victory of the muqawama (armed struggle). Eyad saw something different: an unfolding strategy to isolate and quarantine Gaza, to sever it from the West Bank, to impose a new carceral regime that would operate at a remove and by remote control, resorting to direct military force only when prisoners grew fractious and needed to be disciplined and punished. What he feared came true. Over the course of the last decade, protracted siege, punctuated by bouts of extreme and escalating violence, have made life in Gaza increasingly unbearable. Eyad was diagnosed with cancer in 2007. Despite his illness, he worked on. In 2009, he started the International Campaign to End the Siege on Gaza, and organized the Freedom Flotilla that brought a series of solidarity delegations. He continued to meet with visiting diplomats and the occasional U.S. congressman. He pressed for engagement with Hamas, arguing that its democratically elected government had been denied a chance to rule through CIA-backed coup attempts and an international embargo. During the last year of his life, Eyad underwent extensive painful treatment. He never complained. From his hospital bed in Tel Aviv, he sat for hours with an Israeli friend drafting the concept of a long-term hudna, or cease-fire, that would give “both peoples a chance to breathe and to hope.” [21]

 

Eyad died six months before the 2014 war on Gaza. Many of his friends wish that he had been there to make sense of the catastrophe. Others say he was spared. Eyad’s protégé, Ziada, the psychologist, lost five members of his family. “Even before this war, Gaza was a place where everything you did to make a decent life could suddenly be undone,” he said. “People feel they have no control of the future. Change can come only by ending the blockade, by allowing a normal economy where it becomes possible to work and earn, to hope and create. A single political decision by Israel will make much more difference than therapeutic treatment or donor aid. The war has made me ask essential questions: What is your relation to life, and to the life of others? What lies behind the mentality that conceives and implements a doctrine of killing whole families? And how to provoke the humanity of the Israelis? How to make them look into the mirror and see reflected back our loss and pain?

 

“Israel wants unconditional surrender. This will never happen. The root of the problem is occupation. It must be addressed in all I do: if not, then I collaborate with the aggressor and prepare the victim for the next round of violence.” [22]

 

Paul Gaston Aaron is a writer and researcher who worked closely with the late Dr. Eyad El Sarraj, Gaza’s pioneering psychiatrist.

 

ENDNOTES

1 Eyad El Sarraj, interview with Dr. John R. Van Eeenyk, 2010.

2 “From the 1948 Nakba to the 1967 Naksa,” BADIL Occasional Bulletin no. 18, June 2004, www.badil.org.

3 Eyad El Sarraj, interview with Dr. John R. Van Eeenyk, 2010.

4 Eyad El Sarraj, “A Talent for Hope,” autobiographical essay prepared for World Psychiatric Association in conjunction with that organization awarding El Sarraj the 2010 Juan José López Ibor prize, a prestigious award meant to honor and recognize individuals engaged in activities to enhance the human dignity of patients and their families.

5 Eyad El Sarraj,“A Talent for Hope,” 2010.

6 See John Foot, The Man Who Closed the Asylums: Franco Basaglia and the Revolution in Mental Health Care (London: Verso Books, 2015). See also Wellcome Trust, “From Torture to Treatment: One Man’s Fight to Revolutionise Mental Health Treatment in Italy,” blog post, text and video, 10 July 2014, http:blog.wellcome.ac.uk/2014/07/10/from-torture-to-treatmentone-mans-fi... John Foot, “Franco Basaglia and the Radical Psychiatry Movement in Italy, 1961–78,” Critical and Radical Social Work 2, no. 2 (2014): pp. 235–49, doi:10.1332/204986014X14002292074708.

7 Eyad El Sarraj,“A Talent for Hope,” 2010.

8 See the obituary and tribute “Ruchama Marton Remembers Eyad Sarraj,” Israel Physicians for Human Rights, www.phr.org.il.

9 “Ruchama Marton Remembers Eyad Sarraj,” Israel Physicians for Human Rights, www.phr.org.il.

10 “I Will Keep Them from Harm and Injustice,” Get Help Online, www.gethelponline.org/i-will-keep-them-from-harm-and-injustice.

11 Ruchama Marton, interview with author, Gaza, 2012.

12 Hasan Ziada, interview with author, Gaza, 2015.

13 Husam al-Nono, interview with author, Gaza, 2015.

14 Eyad El Sarraj, “Why We Have Become Suicide Bombers,” Mid-East Realities Newsletter 1, 1997, MiddleEast.org.

15 Hasan Ziada, interview with author, Gaza, 2015.

16 Eyad El Sarraj, “A Talent for Hope,” 2010.

17 Eyad El Sarraj, “Doomed,” al-Quds (Jerusalem), 13 October 2000.

18 Eyad El Sarraj, letter that he wrote as head of GCHMP to U.S. secretary of state Colin Powell, May 2002, GCHMP archives, Gaza.

19 Husam al-Nono, interview with author, Gaza, 2015.

20 Eyad El Sarraj, “A Talent for Hope,” 2010.

21 Eyal Erlich (El Sarraj’s Israeli interlocutor), interview with author, 18 February 2014, Tel Aviv.

 

22 Hasan Ziada, interview with author, Gaza, 2015.