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?

http://www.bbc.co.uk/programmes/p03hfg20

For what am I apologising?

This evening the ambulance brought in a 10 year old boy from one of the refugee camps around Jerusalem. He had been shot in the eye by a policeman with a “sponge bullet” and, according to the news report I read later, was in a Moderate Condition (“Matzav Beinoni”).

“Moderate Condition” apparently corresponds to complete destruction of one eye, numerous facial fractures, and a fracture into his other eye.

We intubated him, took him to the OR, where over several hours the surgeons removed the remnants of his eye, fixed and plated a bunch of bones, and brought him to my ICU sedated and ventilated.

I have just finished explaining to the family that his eye has been removed. That he would never see with that eye again. I had to explain it three times, as they went through the naturally difficult process of accepting what had happened to their child.

I tried to soften it by saying that we think we have saved the other eye. That, thank God, he didn’t suffer brain or spinal damage. That tomorrow we hope to wake him up.

And then, I said “I’m sorry”.

To this very moment I’m not sure for what I was saying sorry.

Was it the “sorry” that we were taught in England was a natural way to show sympathy for a patient receiving bad news?

Was it a “sorry” that we couldn’t save his eye?

Was it an apology-in-absentia for the policeman who felt justified in shooting a 10 year old in the face?

Was it a communal apology, on behalf of all Jewish Israelis, for having put that policeman there? For having put the kid in the refugee camp? For almost laughing at Ayelet’s question “was it a Jewish or Arab kid” (who ever heard of a Jewish kid being shot by a rubber bullet in the face?).

I want to blame someone.

I thought about blaming the boy, after-all perhaps he threw stones at the border policeman. But he is a 10 year old, and 10 year olds do stupid things, and should not be punished with gunfire.

I thought about blaming the policeman, but he was possibly facing kids throwing real rocks. He was probably told to guard a particular spot, and had limited ways to deal with the situation.

I considered blaming the family. Shouldn’t they have kept an eye on the boy better? Shouldn’t they have taught him that policemen with rifles are dangerous? Maybe they brought him up to be violent. Who knows? But I can’t blame the grieving parents of a kid who was just coming home from school, my have done something stupid, and will now be disabled for life.

So I have to blame The Situation. The situation where we put paramilitary policemen in close contact with kids. Where we justify the frequent use of violence as being the only way we can assert control, without stopping to think whether we should be there at all. Where most of us will never have to come face to face with the consequences of us blindly letting The Situation continue.

Perhaps I am apologising for my part in that, and for having failed to do anything to improve matters.

Big news!

Rather than my usual musings on Israel, this time I have some personal news.

On Friday I asked my girlfriend, Ayelet, to marry me, and she agreed!

I know that a lot of our friends and family in the UK haven’t yet had a chance to meet her, and I was wondering how to summarise her here in a couple of sentences. Of course I can’t, but I thought I’d string together a few facts just so that you have some image of her.

Ayelet is an Olah Chadasshah (new immigrant like me), who moved from New York to Israel a couple of years ago. She’s a wonderful, caring person; connected to her Judaism, her family and her new home. She speaks Hebrew, Chinese and we are working on teaching her English too!

She also very much enjoys exploring the countryside, and on Thursday we went camping in Wadi Tzin, next to Sde Boker in the desert. On Friday we did the 16km hike up Chod Ekev, with the difficult climb up the side of the valley. I’d forgotten quite how scary the slope could be (at least for someone with my fear of heights – see photos), but somehow we got to the top and enjoyed a spectacular view across the desert.

The climb to Chod Ekev

The top of the mountain

At the summit I asked her if she’d marry me, and to my joy she agreed!

I’m sorry that we didn’t get a chance to contact many of you immediately, but we were racing the sun to get off the mountains before dark and the Sabbath, and then spent the next two days in a gorgeous hotel called Beresheet overlooking Machtesh Ramon. It was one of these places that really pampers you, with massages and private swimming pools and fantastic food. They are also right on the edge of the desert, so wild ibexes jump the fence to drink from the pools and one of them came and ate our left over carrots and cucumbers from the hike, from our outstretched hands!

We’re now back in Tel Aviv. Life seems a bit of a daze but we are both very happy and very excited at the thought of the upcoming adventure of life together.

Why does it have to be like this?

I have a patient who is only 52 years old and will die in the next few hours. I spent most of the night doing everything I can to extend his life just enough for the family to get here.

At 11pm I spoke to his brother who said he can arrive by 2pm from Ramallah, but unfortunately, because of the situation at the Kalandia Checkpoint, may not be able to arrive sooner. He did however managed to contact the patient’s teenage son who was nearby and who I spoke to this morning.

I can’t even begin to imagine what this boy is going through, trying to deal with the fact that his father is dying, but he managed to put on a brave face talking to me.

When the boy realised how bad things were he asked if there was anything we could do to try to help his mother get to his fathers bedside before he died. The trouble was that she doesn't have a permit to get through the checkpoint.

After I went this them to Hospital Reception (me as a doctor being there may open some doors), we ended up having to just give the teenager a letter saying that his father is a patient at Hadassah and is dying. He now has to take that to various bureaucrats to get the permit. I hope and pray that someone helpful decides to rush it through, because my greatest fear is that while he is off doing this, his father will die alone.

It doesn't need to be like this.

There should be a number I can call for the officer at the checkpoint. A helpful army soldier should pick up the wife and drive her straight to us. Doors should part.

If not, then I'm not sure the son will ever forgive the occupiers, and I'm not sure how easily I could forgive us either.

Hadassah - most issues resolved, waiting on court decision regarding insurance before we can return to work

Most of the strike issues look like they may have been solved, but we are still not insured sufficiently to work safely. This is being discussed in the courts Wednesday, but after that is resolved, it looks like we may be back at work soon.

The end (of the strike) is in sight.

P.S. after that there is still 3 months of hard negotiations to resolve the problems of Hadassah. But at least we will be working normally.

Stop attacking Hadassah Management!

I have just read a seriously disingenuous article in Ynet about Hadassah. They are accusing the managers of continuing to take large salaries, and to support this claim, they quote figures for how much each manager "costs Hadassah" (allowing them to include pension contributions, Keren Hishtalmut, insurance costs etc.)

I know personally one of the managers well: Yoram Weiss used to be head of Anaesthesia before he was asked to take on the role of Medical Director when this crisis became really bad. He did this without any increase in salary (as noted in the paper but then ignored), and knowing that it is a tough and unpopular job. There is no way I would agree to be standing in his shoes right now - not for twice his salary.
I would also say that in his 3.5 years as head of Anaesthesia in Hadassah, he made the department into one of the best places to train in the country, earning the respect of all his Residents. I have no idea how this mess will end, but Yoram seems to be someone who at least has a chance of moving things in the right direction.

I have only seen Avigdor Kaplan (the Chief Exec) from afar, and have only heard him speak twice. However on both those occasions he impressed me with what appeared to be an honest aim to rescue Hadassah, and an inspirational dream of bringing us back to our position at the top of Israeli healthcare. He also came in during the peak of the crisis, also taking on a job that was certain to be unpopular and tough.

I know that we are on strike, but as the doctors' committee chairs said at the start - we are standing side-by-side with the management and asking for the government for support (not just a bailout. The current system of reimbursement for Israeli hospitals prevents almost any hospital from covering its costs).

So whoever thinks it's a smart idea to make these personal attacks on the people who have taken on the challenge of running Hadassah doesn't seem to have Hadassah's interests at heart. Nor those of the population of Jerusalem.

Hadassah - Chapter 11 Bankruptcy Protection

A quick Hadassah update:
Firstly we were told today that the Anglo-Saxon (ie English) term for the process we are in would be Chapter 11 bankruptcy protection.
The deal is that the court appointed executors can impose deals for 3 months on the workers, management and creditors.
After 3 months there are three possible outcomes:
1) everyone agrees to a deal to save Hadassah
2) the Chapter 11 is extended
3) full breakup or bankruptcy of Hadassah. Effectively all the staff lose our jobs and can be Re-employed if the new management chooses and with any terms they choose.

The Chapter 11 was introduced when the hospital could no longer even buy good or basic medicines for her inpatients. Things were pretty desperate.

We are hoping to receive an advance on next months salary I'm the next few days (it is illegal to give us the second half of our January salaries under Chapter 11 terms). That won't be our full salary.
There are however some conditions we are demanding before we give up the strike. These include:
Adequate medical liability insurance cover.
Payment to the Palestinian doctors (they are paid separately and have done even worse than us)
Continued recruitment of trainees as needed.
Plus done other small points.

When the strike will end is still unclear