How social contexts shape Medical Decisions - Story of Anna &Layla

As young girls in Cairo, Anna and Layla strike up a friendship that crosses class, cultural, and religious divides. Years later, Anna learns that she may carry the hereditary cancer gene responsible for her mother’s death. Meanwhile, Layla’s family is faced with a difficult decision about kidney transplantation. Their friendship is put to the test when these medical crises reveal stark differences in their perspectives.

Anna is the daughter of an expat American oil family living in Cairo, and Layla, her Egyptian friend, is the daughter of the apartment building’s bawab, or caretaker. The book opens with Anna’s mother, is diagnosed with, battles against, and succumbs to breast cancer. Five years and thousands of miles later, Anna learns that she, too, may carry the hereditary cancer gene responsible for her mother’s death. Meanwhile, Layla’s family back in Egypt is faced with a difficult decision about kidney transplantation for her ailing father who, due to his faith, staunchly opposes Kidney Transplant. Yet, Layla’s hard-won education as a young doctor places her at a distance from her parents’ traditional views as well as Anna’s medical preferences.

As a medical student doing rounds at the Cairo University Hospital, Layla witnesses a case of advanced cancer. The professor complains, “These ignorant peasants always wait until the last minute to come and get treatment.” Layla boldly responds: “Most people don’t get good treatment even if they do come early! And why should people come to see doctors who think they are ‘ignorant peasants’?!”

At the same time, back in the United States, Anna attends a college lecture on genetics, learns that she may carry a gene, BRCA, that would put her at a higher risk of getting cancer. This leads her to consider her own testing options.

The Book showcases an extraordinary contrast between Layla’s father’s unwillingness to receive a kidney transplant either from a paid donor or from his offspring in Egypt and Anna’s continued research into prophylactic mastectomy in the U.S. As Anna goes under anaesthesia for her prophylactic mastectomy in the US, a revolution breaks out in Cairo.

This book brings anthropological research to life in comic form. Artfully combines scholarly in- sights in visually-rich storytelling to foster a greater understanding of global politics, inequalities, and solidarity and leaves the reader to think how social contexts shape medical decisions.