Walid Fitaihi says he aspired to become “a bridge” between the United States and Saudi Arabia following the horrors of Sept. 11, 2001. He was then in Boston, where he lived for most of the 1990s and where he obtained a degree in public health from Harvard, along with U.S. citizenship. Before that, he had earned bachelor’s and medical degrees from George Washington University.

To a remarkable extent, Fitaihi succeeded. He returned to his native Jiddah to found the International Medical Center, a 300-bed hospital that was inaugurated in 2006 by then-King Abdullah. Fitaihi recruited scores of U.S.-trained doctors and partnered first with the Cleveland Clinic and later with the Mayo Clinic to import U.S. health-care standards to Saudi Arabia. U.S. diplomats working at the consulate in Jiddah frequently came under his care. Meanwhile, the charismatic doctor became a motivational speaker, attracting millions of viewers to his videos on wellness, along with 1.7 million Twitter followers.

Fitaihi’s reward for all this came in November 2017, when he was suddenly arrested by the security thugs of Crown Prince Mohammed bin Salman. Along with scores of other Saudi businessmen and royal family members, he was confined to the Ritz-Carlton hotel in Riyadh. Like many of them, he was tortured. But unlike most, he was not freed after a few weeks; instead, he was held for 21 months without trial.

When he was finally released and brought to trial last July, one charge announced by Saudi prosecutors was all too telling: obtaining U.S. citizenship “without permission.” In effect, Fitaihi was targeted precisely because he had succeeded in becoming an influential voice in the kingdom with strong U.S. connections. “They kept asking me, ‘Why do you have so many followers?’ ” Fitaihi told me in an interview last week. “For them, the fact that I was an American only made it worse.”

Fitaihi’s story underlines the mounting contradictions of U.S. relationships with longtime Arab allies, including Egypt, Bahrain and the United Arab Emirates as well as Saudi Arabia. Most of these nations, as then-businessman Donald Trump once pointed out, wouldn’t exist without a U.S. defense shield. Yet, as their regimes have taken a harsh authoritarian turn in the past decade, they have become increasingly unwilling to heed U.S. interests, and ever more suspicious of those in their societies who advocate American values or have links to the United States.

One result has been a steady stream of imprisonments of U.S. citizens. In addition to Fitaihi, Mohammed bin Salman has jailed two other Americans: Salah al Haidar, the son of a prominent Saudi feminist activist, and Bader al Ibrahim, another physician and respected writer. Both are still imprisoned. Egyptian ruler Abdel Fatah al-Sissi is holding at least five Americans; another, Mustafa Kassem, died in prison in January, 6½ years after he made the fateful mistake of identifying himself to police with his U.S. passport.

Fitaihi himself is back at work at his hospital, which recently set aside two floors and 80 beds for covid-19 patients. But he is not yet entirely free. The judge has yet to issue a ruling in his trial; the proceedings have been repeatedly postponed, to the growing frustration of U.S. officials. In the meantime, he and seven members of his family, all U.S. citizens, are banned from leaving Saudi Arabia, and their Saudi assets are frozen.

The Trump administration can’t be accused of ignoring Fitaihi’s case. It has lobbied for him repeatedly and at the highest levels. Before visiting Riyadh in February, Secretary of State Mike Pompeo said publicly that he planned to bring up the doctor’s continued persecution. Presumably he did. But that’s just the point: Mohammed bin Salman regularly ignores appeals from Washington, whether about jailed U.S. citizens or oil production, even as he leans on thousands of U.S. troops dispatched by Trump to protect Saudi oil fields.

Last month, Trump finally seemed to lose patience with this highhanded treatment. According to Reuters, he called the crown prince and threatened the withdrawal of U.S. forces unless the Saudis cut oil production — a demand that he and Pompeo had been unsuccessfully pressing for nearly a month. The Saudis complied, though only after oil prices had crashed below zero.

Human rights cases don’t get the same presidential attention. Trump has never spoken out about Fitaihi or any other American prisoner in Saudia Arabia. He did nothing to free Kassem in Egypt even after the desperate American wrote to him personally.

Fitaihi says he hasn’t given up on his mission. He said he’s working to open a new medical school connected to his hospital and is looking for a U.S. partner. “I would like to continue to be a bridge between the two countries,” he said. Yet as his own story shows, while Mohammed bin Salman rules, U.S.-Saudi partnership isn’t likely to flourish.

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