How the Muslim Ban Hurts Rural Health

Summary

Podcast Summary: "How the Muslim Ban Hurts Rural Health"

The Political Scene | The New Yorker
Host: Dorothy Wickenden
Guest: Dr. Ali Fadil, internist in rural Georgia
Date: February 3, 2017

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Main Theme & Purpose

This episode delves into the immediate and profound impacts of President Donald Trump's executive order—popularly known as the "Muslim ban"—on rural healthcare in America. Through a personal and professional lens, Dr. Ali Fadil, an Iraqi-born internist practicing in small-town Georgia, explains how the policy disrupts his life, the lives of his colleagues, and the rural communities that rely on immigrant medical professionals.

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Key Discussion Points & Insights

1. Dr. Ali Fadil’s Background and Journey to America

• Dr. Fadil’s Early Connection to The New Yorker:
  Fadil began as a translator and fixer for writers such as George Packer during the Iraq War. He recalls a life-threatening moment when, sensing danger for himself and Packer, he made a quick decision to leave an interview with a Sunni tribal family suspected of plotting a kidnapping.
  Quote: "They were talking among themselves about how much George Packer [was] worth in terms of dollar money... I decided this is getting dangerous." – Dr. Ali Fadil (02:24)
• Family and Final Departure from Iraq:
  Danger in Iraq persisted, even after moving to the U.S. He kept returning to work on documentaries until 2008, when he felt compelled to settle for his family's safety.

2. The Rural Southern Hospital: A Microcosm of U.S. Healthcare

• Role of Immigrant Medical Professionals:
  Dr. Fadil paints a vivid picture of rural hospitals: about 85–90% of internal medicine staff are immigrants from countries like India, Sudan, Ethiopia, and Iraq.
  Quote: "The majority are immigrants... I think 96 physicians." – Dr. Ali Fadil (04:41)
• Close Relationship with Patients:
  He describes efforts to maintain personal connections, routinely checking on patients after discharge.

3. Community and Workplace Reactions to Politics and the Ban

• Political Climate Among Patients:
  Dr. Fadil often faces questions about his political opinions. Many patients defend Trump, dismissing his anti-immigrant rhetoric as political posturing, though the ban proved otherwise. Quote: "'This is just politics,' they would say. 'A Muslim ban will never happen.' It wasn't so reassuring when this happened Saturday." – Dr. Ali Fadil (06:27)
• Conversations with Immigrant Colleagues:
  The Muslim ban incited anxiety among peers. Physicians were stranded abroad or afraid to travel, jeopardizing rural health care contracts they had with American hospitals.
  • Example: Colleague from Sudan barred entry while en route for a new job in rural Georgia.
  • Another Example: Friend in Texas unsure if he’d be allowed re-entry after visiting his family abroad.

4. The Central Irony: "Good Immigrants" and Unintended Consequences

• Impact on Healthcare Staffing:
  The ban directly hampers hospitals’ ability to fill internal medicine positions—roles Americans largely avoid due to high stress and lower pay.
  Quote: “A lot of these jobs will be empty, vacant. I don’t know how they’re going to fill these jobs. It’ll be very difficult without immigrants.” – Dr. Ali Fadil (09:52)

5. Patient Awareness and Healthcare System Fragility

• Disconnect Between Policy and Patient Reality:
  Many patients—often Obamacare recipients—don’t recognize that policy changes (like rescinding Obamacare or the travel ban) will worsen their access to care.
  Quote: "They’re going to come to us with more terminal illness... I feel sorry for them even though they don’t understand it." – Dr. Ali Fadil (11:30)
• Costs of ER Visits vs. Primary Care:
  Dr. Fadil notes the massive cost difference—a $7,000 ER visit versus a $250 primary care appointment.

6. The Personal Toll: Family and Social Climate

• Rising Hostility and Bullying:
  The charged political atmosphere led to direct bullying of his children in school—being called "Sarah ISIS," mocked with vulgar songs, and questioned about ties to terrorism.
  Quote: “Sarah’s nickname became Sarah ISIS... She says, the song is about how Arabs mate with camels.” – Dr. Ali Fadil (13:30)
• Shift in Children’s Identity:
  Previously self-identified as Americans, Dr. Fadil’s kids began to feel othered after the 2016 campaign. His daughter wore a "What Would Jesus Do?" bracelet to deflect harassment.
• Family Decision to Relocate:
  Experiencing unaddressed school harassment and rising local hostility, Dr. Fadil decided to move his family to California, despite financial drawbacks, seeking a more inclusive environment. Quote: "We thought about the options between California and the Northeast... Nobody’s gonna differentiate." – Dr. Ali Fadil (17:46)

7. On Seeing Trump’s Appeal and the National Climate

• Perception of U.S. Populism:
  Drawing from experience in Iraq, Dr. Fadil recognized the power of radical rhetoric and foresaw Trump’s possible victory when most doubted it.
  Quote: “He was using a language very similar to our politicians back home... the extremists are the ones who win the election.” – Dr. Ali Fadil (16:04)
• Losing Faith in Community Integration:
  Even before the election, local attitudes convinced him his family’s future lay elsewhere.

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Memorable Quotes & Moments

• On Why He Moved to the U.S.:
  "In 2008, I decided, okay, it’s time for my family. Iraq at that time was just not doing any better, and things were just getting worse and worse." – Dr. Ali Fadil (03:38)
• On Rural Healthcare Being Predominantly Immigrant-Driven:
  "The hospital group... mostly immigrants. I would say about 85%, 90% are immigrants." – Dr. Ali Fadil (04:41)
• On Unspoken Patient Prejudices Revealed in Vulnerability:
  "[Hospital patients] speak their mind, their hearts... In my hospital, we both saw it: patients come in, and it’s Trump, Trump." – Dr. Ali Fadil (16:52)
• On the Future for His Children:
  "[Sarah] wants to be super rich and go to Hawaii and live in Hawaii." – Dr. Ali Fadil (18:34)

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Important Timestamps for Key Segments

• [01:46] – Introduction of Dr. Ali Fadil and recounting his work with The New Yorker in Iraq
• [04:41] – Discussion of the immigrant makeup of rural hospital staff
• [06:27] – Emotional reaction to the Muslim ban and experience with colleagues
• [09:52] – The direct impact of the ban on hospital staffing and healthcare delivery
• [11:30] – Analysis of Obamacare’s impact on patients and the disconnect in understanding consequences
• [13:03] – Personal stories of Dr. Fadil’s children facing anti-Muslim bullying at school
• [16:02] – Dr. Fadil discusses why he anticipated Trump’s electoral victory
• [17:46] – Explaining the choice to relocate to California for a safer, more inclusive community

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Overall Tone and Takeaways

The conversation is candid, urgent, and deeply personal. Dr. Fadil’s anecdotes highlight both the indispensable role of immigrant professionals in rural American health and the threat posed by exclusionary policies. The episode blends policy analysis with on-the-ground realities, humanizing the broader debate over immigration and health care through the lived experiences of one rural doctor and his family.

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For listeners:
If you want a glimpse into how political decisions ripple through American communities—and the often invisible hands that keep our health systems alive—this episode is essential listening.

Transcript

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[Dorothy Wickenden]

This is the Political Scene, a weekly conversation with New Yorker writers and editors about Politics. It's Friday, February 3rd. I'm Dorothy Wickenden, executive editor of the New Yorker. Last week, Donald Trump issued an executive order banning immigrants from seven Muslim majority nations.

[Donald Trump]

I'm establishing new vetting measures to keep.

[Dr. Ali Fadil]

Radical Islamic terrorists out of the United States of America. We don't want them here.

[Dorothy Wickenden]

I'm joined by Dr. Ali Fadil, an internist in rural Georgia, to talk about some of the unexpected consequences of that decision. Dr. Fadil, welcome. I'm so glad to talk to you.

[Dr. Ali Fadil]

Thank you.

[Dorothy Wickenden]

I want to go back many years now because I remember first hearing about you from my colleague George Packer during the Iraq war when you were working with him as a translator and fixer in Iraq. And I yeah, that's true. He sends his regards, by the way. I think the reason I remember is because he said at the time that his life depended on you. I don't remember where it was, but you were in a particularly dicey situation. Do you remember that incident?

[Dr. Ali Fadil]

That's True. I remember that very well. I mean, I'm smiling right now. I just remember all of that. It was in a house of one of the Sunni tribes there in Kirkuk. Basically, when we were talking to them, usually these guys are very, very nice people, and they like guests and they protect guests very well. But for some reason, guys we were interviewing in that house, that particular house, in the living room, suddenly they were talking among themselves about how much George Packer worth in terms of dollar money. And that was for me. That was for me. That was it. So it's basically they were thinking about ransom and stuff like that at that time. It was the hype of the kidnapping and all these things, all the bad things started. And, yeah, I decided this is getting dangerous specifically because they were whispering. They weren't really, frankly honest with us. Yeah, I decided to cut the interview short and get out of there. I remember George was really mad at me, so.

[Dorothy Wickenden]

But this was really. This was very dangerous work for you, too. You had a young family at the time, did you not? At what point did you decide this was getting too dangerous and you had to leave?

[Dr. Ali Fadil]

Well, until 2008, when I finally said, okay, that's it. I need to focus more on my family. Even when I came to the United States, I kept going back to Iraq, working on documentaries for HBO and others. But in 2008, I decided, okay, it's time for my family. Iraq at that time was just not doing any better, and things were just getting worse and worse.

[Dorothy Wickenden]

Now you live in a small town in Georgia and you're practicing as a doctor again. You're a primary care doctor. Do you develop relationships with your patients, or is this. You see them and then you move on to the next?

[Dr. Ali Fadil]

Well, we see patients coming through the ER in their worst shapes and all kinds of conditions. I do develop relationships with my patients. I keep calling them back over the phone even after they leave the hospital, make sure that they're doing all right, especially the ones who are really sick.

[Dorothy Wickenden]

And what are your relationships with the nurses, the staff members, other doctors you work with? Are there other immigrant doctors?

[Dr. Ali Fadil]

Oh, mostly. Actually, the hospital group, which is the internal medicine section of the hospital, is mostly immigrants. I would say about 85%, 90% are immigrants. They're either Indians, Sudanese, Iraqis, Ethiopians, all kind of nationalities. So we're like, I think 96 physicians.

[Dorothy Wickenden]

Wow.

[Dr. Ali Fadil]

The majority are immigrants.

[Dorothy Wickenden]

Well, that is really interesting. So. And what are your interactions with your patients like, given that? Do you talk politics with them? Is there. This has been a rather tumultuous time in American politics.

[Dr. Ali Fadil]

Well, not until recently. So with the primary, the Republican primary, that's when things started getting, well, I would guess more interesting. And of course, the majority here are white Republican voters. So, yeah, we talk about Trump, we talk about various issues, including immigration and other issues.

[Dorothy Wickenden]

And is there any tension in these conversations? I mean, I don't know how much you get. Obviously they know that, that you are an immigrant. We've just had this enormous eruption with accompanying Donald Trump's executive order. How does that play out in your work?

[Dr. Ali Fadil]

So after the Muslim ban last Saturday, I have not gone back to the hospital yet. It's my week off. But before then, when we were talking about immigration and when they say, aren't you happy Trump is president, I usually reply with, no, I'm not. I voted against him. And they would say, why? And I explained to them my concerns that he does not want people like me in this country. And they would say, no, don't listen to what he says. This is usually just a political talking point and it's not something that he really is going to do. Actually, one of my colleagues physician with me, he happened to be American and born here. He said that Muslim bans will never happen. Don't listen to this. This is just politics. It was amazing when this happened Saturday. It wasn't so reassuring.

[Dorothy Wickenden]

And what about the other immigrant doctors? Presumably you have had many conversations with them in the past year trying to figure out how all of this was going to play out.

[Dr. Ali Fadil]

Well, definitely since Saturday have been surge in conversations about this. I've had phone calls from Iraq, from even from Sudan. Some of my colleagues whom we trained with together during residency, actually the entire residency, they're all made of immigrants because usually internal medicine, not many Americans want to go into it. It's a not that well paid, it's overworked profession. So usually immigrants coming from mostly from these seven countries, I would say, come into these programs. So, for example, I was talking to my friend Mohammed Altirmizi. He's in Sudan. He was taking off the airplane in Doha on his way coming here to the United States, to Atlanta. He was accepted as a physician, as a hospitalist in a hospital south of Atlanta, about 100 miles south of Atlanta. And it happened that I worked in that hospital in the past. It's in a very rural area and it's mostly white voters, mostly Republican voters. These people will be affected because no one wants to work there. It's far away from any big city. He signed a contract with them to work for four years in that area on an H1B visa, but he was denied entry into the United States. Other colleagues, a friend of mine in Austin, Texas, who works there right now, he was about to leave the country to see his mother. He hasn't seen her for eight years. But shortly before he leave, this band came in and he was really mad about this. He has a green card and he doesn't know if it's really wise to leave the country. Whether he's going to be able to come back in or not and leave his life here behind. It's just difficult. And lots and lots of other examples.

[Dorothy Wickenden]

It also shows the unintended consequences of what the Trump administration is trying to do. Didn't Trump repeatedly say during the campaign that he wanted good immigrants, not bad immigrants, which was the way he put it, meaning immigrants in professions like rural health care.

[Dr. Ali Fadil]

Well, you know, this is ironic because the residency I come from Atlanta Medical center, mostly uninsured people, very poor people coming in their end stage diseases. This is where I trained with, I would say 28 other residents. Most of them are immigrants. Usually this time of the year is when the residency match system is already, the interviews are already done and they go through the matching and placing people through the roster for the match. The problem is I was just talking to my program director this morning and basically it's, they don't know what to do because a lot of these people they interviewed, they're from Iraq, from Sudan. She, I mean, she literally said about 30% of people from Sudan, 30 from Iraq. It's just there's a lot of people coming from these countries and they have to go through this whole process. The problem with the H1B visa, you have to leave the country and get the visa issued in the country of origin. So, so they have to leave back to Iraq to get the H1B visa. And that's never going to happen. So meaning these residents who are responsible for so many patients on daily basis, these programs will be affected. A lot of these jobs will be empty, vacant. And I don't know how they're going to fill these jobs. It's going to be difficult without immigrant people from these countries or even other countries. It'll be very difficult.

[Dorothy Wickenden]

And do your patients understand the ramifications of some of this? That they may come to the clinic and not have the doctors they need to take care of the conditions they're suffering from and that when Obamacare vanishes or is whatever, there are going to be consequences for themselves and their families.

[Dr. Ali Fadil]

So ironically, even the patients who have Obamacare, when they come to the clinic, they are furious about President Obama. I keep explaining to them that for us as doctors, it's probably better financially for the Obamacare to go away. But for you patients, you're going to be affected more, you're going to come to, to us with more terminal illness. I've seen it in Atlanta where I've seen people uninsured come with end stage cancers, end stage all kinds of diseases, even though these are somewhat treatable at earlier stages, but they don't have insurance, they can't come to the hospital, they can't come to the primary care physician where all these screenings should be done. So they end up going to the er. The emergency department becomes over flooded and of course the emergency department cost way more, probably 300%, 400% more than actually even more than a primary care visit. Compare $7,000 to $250 in a primary care. The ER cost at least $7,000. So they don't understand the ramification of all of this. And I don't know how they're going to survive without Obamacare, without something, an alternative to it. It's going to be difficult for them. I feel sorry for them even though they don't understand it. They don't fathom the idea yet, but I'm pretty sure they're going to feel it pretty soon.

[Dorothy Wickenden]

Katie.

[Katie Drummond]

I'm Katie Drummond. I'm Wired's Global Editorial Director.

[Dr. Ali Fadil]

I'm Michael Colori, Wired's Director of Consumer Tech and Culture.

[Dorothy Wickenden]

And I'm Lauren Good. I'm a senior correspondent at Wired. And our show Uncanny Valley is all about the people, power and influence of Silicon Valley.

[Katie Drummond]

At Wired, we're constantly reporting on how technology is changing every aspect of our lives. So each week on the show, we get together to talk about one of the biggest stories in tech.

[Dr. Ali Fadil]

Right? So whether we're talking about privacy, AI, social media, or a major tech figure, we will always explain the Silicon Valley forces behind these stories and how they affect you.

[Katie Drummond]

Make sure you're following Uncanny Valley in your podcast app of choice so you don't miss an episode.

[Dorothy Wickenden]

So I want to go back and ask you a little bit more about your own situation and your family. I understand you're leaving Georgia, so that's correct.

[Dr. Ali Fadil]

Back in late 2015, early 2016, when Trump was in the picture and when the Republican primary was at its ugliest moments, things started to change here at home in Suwanee, in my area, my kids started hearing things about Muslims about ISIS and stuff like that. I have two kids, Sarah, she's 13, and Adam, 11, both in middle school. And so a lot of ugly things happened to them at school. So Sarah's nickname became Sarah, Isis and Adam, they were asking him about his relation to ISIS and if he's a relative of ISIS and so on and so on. So they come back home, they're furious from the bus, Sarah would be ranting. As soon as she get home, she says, this girl behind me in the bus, she keeps playing the same song every day behind my ear.

[Donald Trump]

And.

[Dr. Ali Fadil]

And when I asked her what the song is about, she says, the song is about how Arabs mate with camels and stuff like that. Very vulgar songs.

[Dorothy Wickenden]

Did they. And they hadn't experienced anything like this before?

[Dr. Ali Fadil]

Not really, no. Before, we used to. I mean, even here in Suwanni, we didn't feel anything like that back in Atlanta. We didn't feel anything like that when we used to live there a couple of years, three years ago. So we never felt this before the primaries, before the election. But when Trump came in power, I mean, when he won the primaries, as soon as this new school year started, things really escalated. This became a regular thing. I complained to school, the kids went to their counselor, and nothing really happened. They kind of. Yeah, my daughter started wearing a. What would Jesus do? Braces. Bracelets. I'm sorry. Just so that she can. She says, if I wear this, nobody's gonna ask me. This way. I'll. It'll be easier for me. The day will be easier. So that's what they're doing right now.

[Dorothy Wickenden]

Has it changed? I'm interested in them as American children. At least that's how presumably they saw themselves until the past six to nine months. Talk a little bit about that and whether this has changed their feelings about their country.

[Dr. Ali Fadil]

Well, I started hearing a lot of bad words here at home, like rednecks and stuff like that. So, to be honest with you, myself, I didn't do a good job initially. With the hype of the election. I myself became so polarized. So I agreed with them in these terms. But once the election happened and the morning after, I felt that we made a big mistake. So we decided at home not to ever use the word, the terms rednecks, white supremacist, or racist and all these things, just to say that these people are ignorant. That's basically why they're saying this, and they need to understand better. Meanwhile, when Trump won the elections, the primaries, I immediately said to my wife, Zina, we have to Search for a job in California. This guy is gonna win. There's a possibility he's gonna win.

[Dorothy Wickenden]

You thought he was gonna win?

[Dr. Ali Fadil]

Oh, yeah. Against the odds of my friends, against the odds of my wife was saying, you're crazy. This is never gonna happen.

[Dorothy Wickenden]

Why did you think that?

[Dr. Ali Fadil]

Because he was just using a language very similar to the language of our politicians back home. He is radical in terms of not the religion, but in terms of politics. In Iraq, the politicians who usually win, they use radical religious terms. So extremists, the extremists of the extremist Shiites, they are the ones who win the election. The extremists of the extremist Sunnis are the ones who win the election.

[Dorothy Wickenden]

But did you feel that it was comparable in the United States? We were. Obviously, the media, mainstream media, got this completely wrong, but pluralist America, people thought that this was just beyond the pale. And then when it came down to it, people simply would not stand for this.

[Dr. Ali Fadil]

Well, I did not think that he's gonna win the election. Before the primaries, when he won the primaries, it was very obvious my suspicions were in place. I'll tell you why. Because when you work in a hospital, you usually see people at their worst conditions. And usually they speak their mind, their hearts. And when I see it here in my hospital, even in my wife, she works in the same hospital, a different campus, but the same hospital, we both saw it. Our patients come in, and it's Trump. Trump. And I knew that in this area in the suburbs, Trump is winning. And whether he lost the election or not, at the end, this area is just not a place for me to live.

[Dorothy Wickenden]

So where are you going?

[Dr. Ali Fadil]

So right now we're going to California. Actually, I'm incurring a huge financial loss by moving to California. We thought about the options between California and the Northeast coast because these are the places that we know we are gonna melt with the rest of the population easily. Nobody's gonna differentiate.

[Dorothy Wickenden]

So are the kids on board with the move?

[Dr. Ali Fadil]

Believe it or not, they're really excited about it. They're tired about all of this. For them, seeing Trump on the TV and connecting this with what they're seeing in school is just too much. It's a daily psychologically tormenting issue for them, especially my daughter Sarah. She's very active politically, and this became a passionate issue for her.

[Dorothy Wickenden]

What does she want to do? Does she know yet when she grows up?

[Dr. Ali Fadil]

She does she want to be super rich and go to Hawaii and live in Hawaii.

[Dorothy Wickenden]

Good for her. Well, I wish you all the best of luck.

[Dr. Ali Fadil]

Thank you so much.

[Dorothy Wickenden]

Thank you very much for coming on. Dr. Ali Fadil is an internist in Northern Georgia. This has been the political scene from the New Yorker. You can subscribe to this and other New Yorker podcasts by searching for the New Yorker in your podcast. Apply, rate and review the political scene on itunes. This podcast is produced by Alex Barron and Jill DeBouf for newyorker.com with help from Daniel Wenger. I'm Dorothy Wickenden.

[Donald Trump]

Right now we are living through some of the most tumultuous political times our country has ever known. I'm David Remnick, and each week on the New Yorker Radio Hour, I'll try to make sense of what's happening alongside politicians and thinkers like Cory Booker, Nancy Pelosi, Liz Cheney, Tim Waltz, Ketanji Brown Jackson, Newt Gingrich, Robert F. Kennedy, Jr. Charlemagne, tha God, and so many more. That's all in the New Yorker Radio Hour. Wherever you listen to podcasts.

[Dr. Ali Fadil]

From PRX.