west bank mobile clinic

palestine

one saturday during my pediatrics clerkship i was able to go into the west bank on a mobile clinic day with physicians for human rights – israel (phr-i). phr-i is an ngo that sends volunteer israeli physicians to do clinics in the west bank, has a free clinic in tel aviv for migrants without healthcare coverage, and sends physicians to check on prisoners – especially palestinian political prisoners – in israeli prisons. their overall goal is to see the israeli occupation of the palestinian territories end, a goal which i wholeheartedly support. the reality is that human rights violations and unacceptable disparity in access to basic healthcare will always exist in palestine as long as there is a military occupation. many accuse the group of political action under the guise of medical assistance, but many others realize that the fight for basic human rights for all is far more important than which geopolitical side you happen to be supporting. the occupation is bad for palestinian’s health – therefore as physicians we have an obligation to try to end it, end of story. politics and human rights are not mutually exclusive in this part of the world. many of the volunteer physicians go to the clinics in the west bank not because the palestinians particularly need a free clinic, but out of solidarity. they feel that the occupation is a disgrace and is ruining people’s lives, and they want as many palestinians as possible to know that there are israelis who also want it to end. they want to see the palestinian’s faces, and they want palestinians to see their faces. they want to humanize the conflict. they want to do something.

i am picked up in downtown tel aviv on a rainy saturday morning by a spunky elderly woman driving a rusted out volkswagon golf. though she is not a healthcare professional, she volunteers every saturday at the clinic, which is in a different town in the west bank each week. promptly, the car stalls, and won’t start. she starts freaking out, and we try getting the car to start for about 45 minutes to no avail. i say a little prayer and the car starts! i’m not going to claim it was a miracle, but i have no doubt that God is happy that these clinics are happening. then, it was off to the border, where we meet up with a group of about 20 physicians and take a minibus into the west bank.

while i go to the palestinian controlled areas (area a) of the west bank all the time, it is technically illegal for israelis. when they do enter as groups, it is almost always under the “protection” of the army. of course, phr-i refuses such “protection” (it would likely never be provided in the first place), as it is precisely what they view as the problem. israelis in area a are well received without a military escort – having one would indeed likely make things more dangerous. it is interesting to chat with the physicians about what other israelis, including their own families, think of their volunteering in the west bank. one doctor goes to the clinics in defiance of his wife’s wishes. she also wants the occupation to end but is legitimately scared for his life. like almost all israelis, she has never been to area a. the doctor rants about the ignorance of most israelis who, if they think about the west bank at all, think of it as a hell-hole that the army needs to control. these are typical israelis in tel aviv, not the settlers. we don’t even need to talk about the settlers. we talk politics, and we agree. this is the first time i’ve ever agreed with an israeli about politics. we start talking about traveling, and i tell him about my trip to lebanon. i’ve never talked to an israeli about lebanon before. he loves it. he would love to go to lebanon if he could.

we go to the town of attil north of tulkarm. we arrive and the town mayor gives a big speech as the group of doctors from israel sit shivering, drinking cardamom-laced arabic coffee beneath a giant photo of yasser arafat. it is honestly beautiful. these two groups of people are supposed to hate each other. no israeli in their right mind likes yasser arafat. but when we choose to swallow our pride, the hate dissipates, and we find ourselves welcomed. hate is often for policies, not people. phr-i is welcomed with open arms by the leadership of every palestinian town they have ever gone to. i spend the day mostly looking into children’s ears with a pediatrician.

the executive director of phr-i, a bro named ran cohen, comes along to hang out at the clinic that day. really cool guy. big white-man afro. gives me numerous high fives. he is at the forefront – indeed phr-i is in many ways the vangaurd – of the “leftist” human rights movement in israel. you know there is something wrong with the perspective of most of society if the fact that you support human rights automatically makes you a “leftist.” the israeli knesset (parliament) is trying to pass a law that would ban ngo’s that are anti-nationalist. this is widely perceived to be an attack on ngo’s that oppose the occupation. ran cohen is the real patriot, fighting for what is right whatever the government legislates. remember, all these israeli physicians are breaking the law just by coming to these clinics in area a. i love it! i give him another high five, just because i can. he’s quoted in news publications all the time. his girlfriend is cool too. she directs documentaries.

at the checkpoint on the way out of the west bank, our minibus is stopped and the young israeli soldier asks the one muslim woman on the bus with a higab to step outside the bus for further questions. this woman is a speech pathologist who lives in israel and was translating for the physicians. racial profiling happens all the time, and one typically just begins to acquiesce to it. but not on this minibus. ran cohen announces that if they need to question the woman in the higab further, they’ll need to question all of us. we all get off the bus. ran has a good long talk with the soldier. it is inspiring to see israelis who care about these issues. in israel, these are my people.

internal medicine in ashkelon

internal medicine ashkelon crew

this was our first clinical clerkship of the year. we did a large number of blood draws each morning. i spent some good time in the emergency department, especially toward the end when i made some orthopedic resident friends who took care of all the little lacerations. every day for ten weeks, four great ladies and i got to commute one hour each way from beer sheva to ashkelon in a school provided shuttle. every day we would drive by the erez crossing into gaza (and i’d wish i could go in), and through the town of sderot which is famous for being the town in israel always hit by hamas rockets (so it is where all the american politicians go for photo opportunities if they want to be known as the israel-loving type). ashkelon is also just a few kilometers from gaza, and barzilai hospital where we were at is having a new rocket-proof wing built. i guess evacuating the emergency department every five minutes during the gaza wars was hampering some people’s style.

thankfully, i found a bro in the hospital who offered me a room in his apartment for a few weeks so i didn’t have to commute as much. later i was able to sleep in a hospital provided room. evening runs along the beach followed by swims in the mediterranean sea were excellent, and ashkelon has a few remnants of its history as a philistine and later muslim city. overall though, nowadays ashkelon isn’t really considered a desirable place to live for many. it has a lower cost of living than many other cities in israel, so there are huge numbers of immigrants, especially from the former soviet union. indeed, all the elderly patients on our ward spoke russian, usually exclusively. at times it was difficult to find a patient on the ward who even spoke hebrew. interestingly – because any jew can move to israel and receive free health care from the state, there are stories of elderly russians who don’t even really want to be in israel moving here in their old age, after being diagnosed with a chronic disease, for example. not the majority of course, but it happens.

the highlight of the clerkship occurred one day in the gastroenterology suite. as the gastroenterologist was pulling the colonoscopy probe out of the patient’s anus, we heard a loud rumble and before we knew it a projectile splattering of moist diarrhea coated everything in the room. as we and gastroenterologist wiped it out of our eyes, we shared a good laugh. medicine is fun!

sri lanka 2013 – getting there and back

welcome to jordan!

i went to the beautiful island of sri lanka over the jewish sukkot holiday in october! the journey there and back was half the fun. it was only financially feasible (dirt cheap, actually!) to fly out of amman, jordan. strangely, the cheapest way to get to amman from beer sheva is to take a four hour bus all the way to the extreme southern tip of israel to cross the border from eilat, israel to aqaba, jordan, and then take another bus five hours north to amman. in eilat i stayed with some of my classmates who were doing their internal medicine clerkship there. thanks to mayuri for letting me sleep in her bed while she was gone! i really wanted to do my internal medicine clerkship in eilat as well but alas the spots were limited and luck wasn’t on my side this time. a frustrating thing about this border crossing is that there is a monopolistic taxi mafia on the jordanian side. even though the city of aqaba is just a few kilometers away, they collaborate with the military to prevent anyone from walking. they charge exorbitantly for the short trip into aqaba and physically accost you when you try to arrange with others to share a cab. the bus from aqaba to amman on jett, the national bus company of jordan, is very pleasant however – there is even a stewardess who makes fresh arabic coffee and sandwiches for passengers on request! in amman i had a few hours to kill, so i smoked way too much shisha and chanced upon a huge brand new beautiful shopping mall called the galleria that had just opened!

after a late night flight to dubai, i slept on the airport floor in terminal 2 (an antiquated terminal for low cost airlines only), and found an excellent breakfast place across the street from the terminal – foul (arab bean paste) with pita and pickles for $1! i then took the metro south to the dubai marina, which is a huge new development that i hadn’t been to yet. there is an excellent mall there, and a new epically tall building that is shaped like a spiral, ostensibly defying the laws of physics! then i took a monorail out onto one of dubai’s massive man-made island paradises called the palm – from space it looks like a palm tree jutting into the gulf of arabia. at the tip of this palm tree is an opulent hotel called the atlantis. after numerous unsuccessful tries, i was able to find my way into the guests-only area through a back entrance. inside the hotel is the largest aquarium tank in the world, which when it was first unveiled contained a whale shark, the largest fish ever to be held in captivity. there is one of the nicest water parks in the world there as well, but unfortunately it is grossly overpriced so i was not able to avail myself of its awesomeness. finished the day at the dubai mall – the largest in the world! the newest proliferating coffee chain in the gulf region is canada’s own tim hortons! there are about four outlets in the dubai mall, which i patronized about as many times! on my way back from sri lanka i again went to the dubai mall and spent an entire day there, because how could anyone ever get enough! kobe bryant was also visiting the mall that day with his entourage as publicity for its huge nike store.

timmies in dubai!
dubai
atlantis, dubai
atlantis aquarium, dubai
atlantis aquarrium, dubai
atlantis lobby, dubai

coming back through jordan i spent a few late night hours discussing islam and christianity with a proselytizing muslim gentleman on the streets of amman. the following day i was able to cross from jordan into israel at the allenby border crossing – the most direct crossing between amman and jerusalem, saving an entire day of buses. interestingly, the reason tourists can cross from jordan to the israeli-occupied west bank but not the other way around (at least without a jordanian visa issued in advance) is that jordan officially still considers the west bank to be part of jordan (as it was before 1967), so will not issue visas at the border because in their view it is not a border. there is also another border crossing between northern israel and jordan – but it is in the middle of nowhere and public transportation is lacking, necessitating expensive taxis. the allenby border crossing is the only crossing that most palestinian residents of the west bank may use – and it is understaffed – so it is insanely overcrowded. it can take hours to push through the throngs of hundreds of palestinians trying to push their way to one or two open windows. there were some elderly women who were quite literally being crushed. more than one palestinian shared with me during the push-fest that they believe israel deliberately understaffs the terminal so as to make the crossing less than easy. then come the israeli interrogations, which in my experience are more intense there than elsewhere. always an enjoyable “welcome home” to be interrogated like you are a criminal.

dubai mall, dubai
dubai

the rest of second year

israel

just from this blog, it would seem that my life is just one holiday after the next. actually, i spend almost all my time studying. m2 as it is called (the second year of medical school) was a lot more interesting than the first, but also significantly more academically demanding. instead of semesters, the courses were divided into “systems,” each lasting two to five weeks and culminating in a final exam. these fascinating systems had titles like hematology, endocrinology, pulmonology, cardiology, gastroenterology, nephrology, musculo-skeletal, reproduction, neurology and neuroanatomy, interspersed with anatomy of the thorax, abdomen, head and neck, limbs, etc. i especially loved the anatomy, as we got to spend our afternoons (and some eerie solitary all nighters too) in the cadaver lab – truly a remarkable place! throughout the year we also had twice weekly sessions on the hospital wards in which we learned various physical exam skills and how to perform a medical interview in hebrew. the hebrew was, and continues to be, rather rough for me. i put in some serious effort though, especially toward the end, and managed to pass the clinical osce (practical exam) at the end of the year in hebrew! overall though it was a great year! i truly love studying medicine, and though sitting around with your face in a book isn’t always the funnest thing one can imagine doing, i wouldn’t want to be doing anything else.

some random other things that happened:

-did some zumba! epic sport! lots of hebrew commands that can be tuned out; just dance! at the first session i was the only male there, with about 60 ladies. at one point our chain-smoking leader makes an announcement in hebrew, and everyone turns towards me and applauds. weird, right? after i learned that it was because i, a male, showed up to a zumba class! lol, a truly special memory!

-during the jewish holiday of purim, we had a customary costume party. before that, my conservative jewish friend read the megillah, or story of esther, in hebrew. a custom during this reading is to make noise with noisemakers and air horns and incessantly boo whenever the name haman is mentioned, because he wanted to eliminate the jewish race. his name is mentioned probably at least 100 times in the story, so lots of booing.

purim, beer sheva

-a new shopping mall opened in beer sheva – the largest mall in israel! some may know that i am obsessed with malls, so needless to say i was living with eager anticipation. it is an amazing place! it even has an h&m, which is probably the most epic thing to have ever happened to beer sheva. one more reason to visit!

 

new mall in beer sheva!

 

-i ran the dead sea half marathon for the second time, with a good group of classmates.

dead sea half marathon crew

-some of my friends organized an excellent ted event at ben-gurion university, tedxbgu. there were a few very interesting speakers. my personal favorite was a blind arab-israeli lawyer named abbas abbas. no one, not even his family or doctors, believed he could amount to anything in life because he was blind and had other disabilities. on top of this, success for arabs in israel doesn’t exactly come easy. against all odds, he was able to graduate with a law degree from hebrew university and founded an organization that seeks to defend the rights of disabled arabs in israel. he was so enthusiastic that he kept shuffling further backwards without realizing it, and was soon speaking from the back corner of the stage. no matter. it was so inspirational on so many levels to see this blind arab commanding the attention of an auditorium full of israelis. doesn’t happen as much as it should, but it did that day. i probably cried a little.

-my roommate and i had two fourth year students from our program live in our apartment for a number of months, minsoo and david. david taught himself a few languages while here, and also self-taught himself how to play the oud, a classic arab instrument. i like to think i played at a least a small part in convincing him to perform a song in arabic at their class’s graduation ceremony, and he absolutely nailed it!

 

medical school for international health class of 2013 graduation

 

student’s day concert, beer sheva

 

night run, beer sheva

WAR. and such

beer sheva, israel

as you may have heard, there was recently a rather significant war in the middle east. call it gaza war # whatever we’re at now. our city of be’er sheva happened to be right in the middle of it. things really got started when the idf (israeli defense force) surprise assassinated ahmed jabari, the head of hamas’ military wing in gaza, as punishment for hamas rockets being fired into southern israel over the last couple years. we got advance warning from the israeli medical students who were taking our neglected tropical diseases module with us – they got some texts from their friends with connections and told us we better go home asap and hide in our bomb shelters, as all hell was about to break loose. and indeed, it basically did. hamas responded with a continuous and sustained barrage of rockets, as did israel, that continued for the next week or so – about 1500 rockets each. it was crazy. no school. no going far from the bomb shelter (which luckily for me happens to be my room). sirens, quickly followed by huge sonic booms that rattled the windows and the fridge. many of be’er sheva’s residents as well as most of my classmates fled town; some even left the country. my roommate and i decided to stick around. soon i started getting cabin fever, and would (probably unwisely) go on runs in the eerily deserted streets, sometimes hiding behind something when the sirens went off, others times simply continuing to run and cranking my ipod to drown out the sounds of war. we had the strange and unfortunate honor of being the center of the world’s attention for a few days. cnn’s wolf blitzer was even tweeting live from close to my apartment – i quickly got on my bike to go try to find him, but he had already moved on to interview some more rocket attack victims.

israel has developed a missile defense system called the iron dome, which shoots down rockets heading toward developed areas with at least 90% accuracy. it is truly beautiful to watch this system in action at night (watch it at work here protecting a wedding – coincidently this is just meters from my apartment: https://www.youtube.com/watch?v=2M-BQtp4Www). one concern has become that the iron dome provides incentive for israelis (and me) to go outside to watch “the fireworks” when the sirens go off, rather than to hide in their bomb shelters. despite the dome, some rockets definitely still get through and hit be’er sheva and other towns in southern israel. for example, one shattered the front window of some of my friends’ house.

and of course, the people of gaza have no such protections, as evidenced by the fact that 160-some gazans died in this latest war compared with six israelis, a gross disproportion fairly typical of israeli-palestinian violence. i have really tried not to make this a blog about my political positions, but allow me to briefly state what i see as the most important root cause of this particular conflict: life in gaza is hell. no economy allowed; no hope. the vast majority of gazans aren’t allowed to leave, ever. they can’t get life saving medicines in for their children without impossible-to-get permissions from israel. israeli doctors who want to go volunteer in gaza are barred from doing so by the israeli government. food going into gaza is rationed. fishermen get shot if they stray more than three miles from the shore – not really far enough to catch many fish. 95% of gaza’s children have clinical signs of ptsd (post-traumatic stress disorder). the list goes on… and on… and on. no one can expect people to live under these conditions without resorting to desperate measures. it is true that hamas is a terrible organization. their stated targets are israeli civilians, which is completely wrong; indeed evil. but the israeli government can’t blame anyone but themselves for the fact that hamas is popular in gaza. and the saddest thing is that not much has changed after the now ceasefire. conditions are still horrible in gaza, and pro-violence hardliners retain popular support on both sides. this war will repeat itself, sooner rather than later. okay, enough from my political soapbox (although i would argue that its not really about politics, its about innocent people’s lives). of course, there are a myriad of other factors that also play into the region’s propensity for conflict, and others predictably point fingers in other directions. just always remember: conflict, especially in the middle east, is invariably more complicated than can ever be described in one paragraph, news clip, facebook sharable infograph, or even dissertation. unfortunately, the only thing that the leaders of both sides agree on is that they probably aren’t going to start getting along any time soon. that doesn’t mean we shouldn’t be doing everything we can to try to help that start to happen.

anyways, about a week into the conflict, things were looking pretty bad. rockets were hitting tel aviv and jerusalem (for the first time since the 1970s), there was a bus bombing in tel aviv that had every israeli worrying about a third intifada, and an israeli ground invasion of gaza seemed imminent. my school’s administration decided that it would be best to end the semester early. ironically, just a few hours after they made that announcement, a ceasefire was unexpectedly agreed to, and actually stuck. so, we got off early, but we need to go back early too, and attend school on weekends to make up the lost time. unfortunately this means i have to miss my main man devin’s wedding which i was really stoked about attending, and spend christmas day on an airplane, and have even less time this spring to start preparing for the biggest exam of our lives, the usmle step 1 board exam, but at least my classmates and i can all be thankful that we survived this thing, unlike the 160 or so who weren’t so lucky. war is terrible.

fall 2012

overlooking the sea of galilee, israel

-studied a lot; passed some exams!

-we started trying to learn clinical hebrew. i am in the beginner group with two good friends, also novices. our teacher is a sixth year israeli medical student and she is really nice.

-got to go on a weekend retreat with some other christians at my school to the galilee! it was so nice to spend some time looking into God’s word, relaxing around a campfire fueled by palm leaves, and getting to know some of the first year students. also, one day we hiked upon mount arbel, which has a huge cliff overlooking the sea of galilee. then a few of us did some seriously muddy off-roading in a field with one of our rental cars and it was totes the funnest thing ever! then on the last day, those in my car and i one-upped any other possible thing that could be done by visiting an outdoor roman-era hot spring/spa facility in the golan heights called hamat gadar. it was funtabulous! they have waterfalls of hot sulfurous water that you can sit under and an extensive alligator farm!

mt. arbel, galilee

hamat gadar spa, golan heights

-joined some of the visiting international undergraduate students at the university for a trip to the western wall in jerusalem to see the prayers of slichot which occur throughout the night before yom kippur. this is the biggest day for public prayer in judaism, seemingly especially among sephardis. the head rabbi of israel was leading prayers at the wall and there were tens of thousands of people fervently praying in their own unique styles. the university had also hired a guide who had many unique insights; we learned a lot about the themes of repentance and forgiveness in judaism; a very interesting time.

prayers of slichot at the western wall, jerusalem

prayers of slichot at the western wall, jerusalem

-ran a nice 10km race in tel aviv in the night along with 30 000 other people, including about half of my classmates! lots of fun!

my parents came to visit me!

there was a long weekend a while ago, and my parents came to visit me in israel! it was so nice to see them and show them what things are like here. the first night was the white coat ceremony for the first year students at my school, followed by one of two gourmet meals of the year provided by the school, and then skits/movies compliments of each of the classes. my parents got to meet most of my classmates which was great! we then went up to jerusalem and saw such sights as the western wall, church of the holy sepulchre, etc., and they even got to experience having rocks thrown at our car late one night as we were lost in the narrow streets of east jerusalem. the next day we went to bethlehem and they got to see the occupation wall and such. after hanging out on the beach in tel aviv for awhile, we headed to the north where we stayed in haifa and went to the historical city of akko, the sea of galilee, and nazareth. considering that i didn’t have to pay for fuel, we even made a foray to the illegal israeli settlement of ariel deep in the west bank – on the way out my parents got to experience their first stringent “security check” compliments of the israeli army. on the way back to beer sheva my dad and i convinced my mom to go swimming in the dead sea, which she ended up really enjoying, and then they got to come to the bible study i go to here in beer sheva. it was nice that they got to see what israel is like, and just to spend some quality time with them. thanks for coming dad and mom!

haifa

bahai gardens, haifa

stars and bucks, bethlehem

bahai gardens, haifa

bahai gardens, haifa, israel

the bahai gardens in haifa is one of the most photogenic places in israel. you can go on a free tour, led by a young bahai person from somewhere in the world other than israel, and learn about the tenets of the bahai faith. the garden is immaculate and you can see northward almost to lebanon on a clear day.

bahai gardens, haifa

bahai gardens, haifa

bahai gardens, haifa

bahai gardens, haifa