Saturday, 26 March 2016

The Shalom Question, the answer, and Hebron

A few months ago a friend (Shalom) asked me what I started to call “the Shalom question”. We were talking about people drifting away from Judaism and the Jewish people, and what, if anything, could convince them to stay. He suggested, as a religious Jew, that he always ended up having to invoke God in some way, and that that was not convincing to someone who didn’t believe. I very much wanted to believe that a convincing reason could be found, that didn’t require faith.

Well, recently I have been reading a book by Jonathan Sacks that has gone a long way towards answering this question for me. He talks inspiringly about how Judaism brought concepts of justice and valuing human life to the world, which, combined with the undoubted achievements of several famous Jews, seems a reason to keep this group going. After all, if we made such a difference to the world in the past, who knows what other contributions may be just round the next corner?

But then I hear this little voice in the back of my head. Every time I read an inspiring line about some important contribution to social justice or individual morality, this voice said “but is that really how things are now? Are we really that moral?”

And then I saw this video of what happened last Thursday in Hebron

People will say that every group has some bad apples, and that the soldier who murdered the unarmed terrorist was immediately arrested and condemned by our leaders.

But the thing is that you see no one around very concerned. Not concerned to provide medical assistance to the injured terrorist, and not surprised or concerned when a soldier points a gun and kills him in cold blood. Here are about a dozen randomly chosen fellow Israelis, and not one objected.

So how am I supposed to believe that somehow we have this high moral standard? Based on this random sample, I have to conclude that a large number/majority of us have no problem with murder.

In his book Rabbi Sacks says the following[AK1] :
“Sholom Ache once thanked God that his people have not been given the opportunity to commit against others the crimes that had been committed against it. Perhaps every nation, once it has power, abuses it.”
Rabbi Sacks however, goes on later to say that he believes that, in the guise of Israel, Judaism will finally be able to put into practice all its moral principles for a good society that for 2000 years remained just theoretical.

I am sorry to say that is not what I am seeing. It seems like we have headed much more down the path warned of by Ache, and by Yeshayahu Liebovitz:
“[Control of the Arab population] will undermine the social structure that we have created in the state and cause corruption of individuals”.

I see no immediate solution, even if I have some ideas.

But for now, whenever I read inspiring lines of text such as Rabbi Sacks’, there will remain a quiet voice of doubt in the back of my mind that we are not such a moral light to the world.


Friday, 4 March 2016

Fortress OR

I am just at the end of my first day/24-hour on-call in the new operating rooms at Hadassah, and after the initial confusion and getting lost, which will probably last for a few months, I started to be struck by a few differences between here and how I imagine a typical OR area would be back in the UK.

Just to give you a sense of the place, it feels huge. I don’t actually know how many ORs we have there (I was doing urology in OR 46, but I think they start at 30). Each OR is large and airy, with multiple flat screens where I can project my anaesthesia monitor, or a live video of the surgery. The ventilators are state of the art, and my anaesthesia trolley contains 90% of the drugs I need, saving my lots of running around. The patient bed seemed so complicated I felt I needed a manual just to work out how to tilt it. It sets of an alarm if it thinks part of it may collide with something, and asks you to press again if you are sure you want to continue.  At one point it decided the right leg was going to hit something (not sure what), and the left one was clear, so it simply split them and lowered one only. I can see we are going to have a few disagreements, but hopefully in the end we will grow to understand each other.

The place is a maze. There is the same grass-green stripe along all the walls, and you really get little sense of where you are, or how anything is related to anything else geographically. I spent a crazy amount of time walking randomly around sometimes returning to where I started, looking for a particular spot (e.g. the OR where I left my patient).

But putting all that aside, I think with a very little investment of time on my part, I will grow to love the place. It feels so much cleaner and more modern than the old ORs.

And then, sometime around 1am when a friend was giving me a tour of the place, I started to notice some of the things that perhaps would not have been seen in the typical NHS Operating Room suits.

Firstly, we are level -4. That’s not a random decision: every Israeli OR needs to be in a protected area in case a rocket siren sounds in the middle of surgery – you can’t very well evacuate the patient in the 90 seconds before impact.

Then I started noticing the doors in the corridor. They are thick steel, with those twisting door handles that drive bolts up and down into the steel doorframe. I found one small corridor between the Recovery Room and the Family Waiting Room with 4 such blast proof doors, spaced roughly every 2 metres.

That started to feel a little strange, but after touring the ORs, we went upstairs (still 3 floors underground) to the on-call rooms and offices. Here the doors were normal. You know, with a normal handle and that thin vertical glass window extending most of the length of the window. The doors were painted metal, which is not unusual in Israel. And then I noticed a curious effect: when I looked through the window from afar, it felt a little like a fisheye lens. I first thought how ingenious this was: you could see someone approaching the door from afar and not push it open into their face. But then I noticed the effect became less as you get closer (which sort of defeats the object), and that there was a slight yellowish tinge to the glass. Then I realised when I had seen this before: it was looking at an angle through the windscreen of a VIPs bulletproof car in the UK.  I may be wrong, but I think someone may have put bulletproof polycarbonate glass into the doors of the anaesthetists’ offices.

Then there were lots of other little surprising touches we found as we explored. Such as the fully working shower-heads in the middle of a corridor (Nuclear, Biological and Chemical decontamination), and what looked like air filters (perhaps for the same reason).

That evening, some of the nurses had returned from a conference where a drug rep had brought food, and they kindly shared it with us in the staff room on level -3. Afterwards some of the people said they were going out for a smoke, and mentioned that there was a staff smoking area nearby. I asked about it (no, I don’t smoke, but I was curious) and was shown to the open window, where you could look down into a pleasant paved courtyard with garden benches. This was around midnight, so I can’t tell if the darkness was natural, but I realised that the courtyard must be 4 or 5 levels underground. I craned my neck upwards but could just see building all the way up. I still don’t know if the top of this void in the middle of our building is concreted at the top, or is open to the sky, but it looks like it would be a difficult trajectory of a missile to enter. I pulled my head back in, and as I closed the window I noticed that it too was in a blast-proof steel frame, with a thick steel shutter you could draw across.  

I don’t now entirely what to make of all this, and would love to chat with the seniors in the department to find out more. It seems overkill if you are trying to defend yourself against the not-uncommon missile bombardments from Gaza or Lebanon (these happen every couple of years). I have wondered if it was nuclear bomb proof, which is not as crazy as it sounds – most of us assume that Iran will get the bomb in the nearish future, and I have been told that the ICU at Rambam hospital in Haifa is in a nuclear bunker. Or maybe it is somewhere in between – I am not expert enough to know if the Scuds of the type fired by Iraq on Israel need this type of protection.

What is certain is that the hospital planners here have some extra dimensions to consider that the NHS management perhaps don’t.

Thursday, 4 February 2016

Finally, something on the BBC about Israel that is not about the Israeli/Palestinian conflict

Just heard the BBC news podcast where they "discovered" that Israel was deporting refugees against their wishes to 3rd party countries.

Ignoring for now that this is hardly a discovery: it has been a matter of public record for ages, and worrying for those of us who care about Israel, but paraphrasing Abba Eban "Israel rarely misses an opportunity to miss and opportunity".

We could have shown the world a model for how to care for refugees. For relatively little social or financial cost we could have absorbed them, provided education and security, and offered them to stay or move and develop as they wished. We even have the infrastructure for immigrant absorption up and ready, with Merkazai Klita, government funded language courses, university discounts, etc.

And the risks would have been so low. We have built a strong barrier in Sinai against more coming, so such simple kindness would not have encouraged more arrivals.
Unlike potentially hostile Syrian refugees the Eritreans clearly are not.

But instead of doing our international duty, and doing what is right in our own eyes, we treat them and continue to treat them terrible, and now we get even worse PR.

When will we learn?