A Remarkable Day in an Israeli Hospital

By Jay Wohlgelernter

 



Have you ever had one of those days when you are just really happy that you went to work? Today was one of those days! I recently started working at Schneider Children's Hospital in Israel as an attending Pediatric ENT.

This morning, one of the other doctors asked me if I could see a baby who had become hoarse. She told me she was very busy and would really appreciate the help. As the new kid on the block and with special training in managing pediatric airways, I obviously said yes, even though my clinic was bursting at the seams and the wait time for my patients was already approximately 2 hours.

When I finally called in this sweet little eight month old boy, I learned that he had undergone open-heart surgery for a congenital heart defect two months earlier. Since his surgery he had developed severe hoarseness and was coughing during feeds. His twin brother who had also undergone heart surgery was waiting outside with his grandmother.

I apologized for the long wait to his mother and grandfather, who came in from Jerusalem to help his daughter with her twin boys. Once I examined his larynx with the fiber-optic endoscope, the suspected diagnosis of vocal cord paralysis was confirmed. This is unfortunately a recognized complication of open-heart surgery in young children.

After I explained the diagnosis, prognosis and the future plan to his mother, as well as setting up an appointment to have his swallow function evaluated, his grandfather who had been quite fidgety during the whole encounter, turned to me and asked if I was American or British. I smiled and told me neither. I'm Canadian. His daughter was embarrassed and informed him that Canadians hate being mistaken for Americans. He then looked me in the eyes and told me that a Canadian doctor had one saved his life. He thought for minute and said that his name was similar to mine and sounded something like Dr. Jay.

I asked for more details and he proceeded to tell me that he attended the doctor's wedding. I lowered my voice and asked him what his name was, although by then I already knew. His eyes widened as he said "Rahamim Mizrahi". I felt lightheaded and got up from my chair. He started to cry and ran over to me. He gave me a big hug and kiss. He grabbed the back of my head and asked what happened to my ponytail.

I think some background information would be in order here: Around 10 years ago I used to work as a doctor on a mobile intensive care ambulance in Jerusalem. One cold winter night at around 3:00 AM we got called out to a home in the neighborhood of Gilo. A 59-year-old man who had suffered in the past from two heart attacks as well as coronary bypass surgery, rolled out of his bed and was "dead" on the floor.

A regular ambulance arrived on scene approximately 15 minutes before us and started CPR. From my experience, the effectiveness of basic rescuer CPR was very limited in its ability to maintain adequate levels of oxygen to the brain. A quarter of an hour would almost certainly result in irreversible brain damage. Once on the scene, we immediately started a full resuscitation including mechanical ventilation, intravenous medications and repeatedly shocking his heart with a defibrillator in what appeared to be vain attempt to jump start it again.

After about 20 minutes my paramedic turned to me and said "Dr. Jay, just call it." Meaning I should recognized the futility of our actions and pronounce him dead. At that time it seemed like the right thing to do. However, this was a 59-year-old man lying on the floor in his bedroom. His wife and 18-year-old son were watching us throughout the whole ordeal and praying for their father to stay with them just a little longer.

According to my monitor, he still had what appeared to be electrical activity in his heart. This is despite the fact that he hadn't had a pulse now for nearly forty minutes. I instructed my team to keep on with the resuscitation efforts until we either get his heartbeat back or all signs of activity in his heart cease. Finally, after we had been working on him for 45 minutes, administered countless drugs and delivered a total of 16 powerful electrical shocks to his chest we got a heart beat. It was weak, it was thready but it was real. We loaded him on the gurney to the ambulance unconscious, mechanically ventilated, and likely never to recover any sort of meaningful life.

Sirens wailing through the deserted streets of Jerusalem, we rushed him to the Sharei Tzedek emergency department. I did not feel good about this resuscitation. I did not feel like we were heroes or lifesavers. I figured, at best, he would die within the next few hours and at worst he would live for a few years as a vegetable breathing through a hole in his neck and eating through a tube in his stomach. I had seen it countless times and I wouldn't wish it on anybody. I distinctly remember the doctor in the ER looking at me and asking cynically why I even bothered resuscitating him.

Although, on an academic level, I was interested to know what had happened to him, the whole incident left me feeling pretty lousy and I didn't follow up on his condition. I guess that is one of the cold mechanisms that we employ to shield ourselves from the abject suffering to which we are exposed; close the chapter and move right on.

Around two months later I got a strange call from a woman who claimed to be his daughter. She had some difficulty finding me but wanted to update me on his progress. After lying in the ICU for two days, he awoke from his coma. He was somewhat confused and suffered significant memory lapses. For example, he thought his twenty-year-old daughter was still in sixth-grade and was wondering why she hadn't finished her homework. This confused state lasted for two more weeks. Then, one morning, he woke up and his memory was back. He was completely oriented and aware of everything that happened. A full recovery by any standard!

From that time on, his daughter had made great efforts to locate me because they wanted to have a Thanksgiving party and they didn't want to have it without me present. I was both shocked and thrilled. It was a great party, delicious food, and a far more festive atmosphere then the previous time I had been at his house. This reunion was followed a few months later by Rahamim's attendance at my wedding where we all danced with unmitigated joy.

That was nine and a half years ago.  Since then I have often thought about Rahmi, as he likes to be called. Every time a patient in serious condition, or a family member, has asked me if there is hope he comes to mind. I always tell them that miracles can happen and I've even seen a few in my life. That being said, within a short time we fell out of touch. As before, I never made any significant efforts to find out what happened to this remarkable man because I was afraid that I would not find him alive. His prognosis, after what his heart had been through so many times, was poor.

Once again, after our serendipitous, emotional reunion today I am amazed at what the human spirit and body can overcome. He remembered in perfect detail my father, and that he is a psychiatrist who was interested in talking with him about his experience being clinically dead for an hour. He remembered how my father took him around the wedding to bless the various guests. He remembered my wife and gently reprimanded me for flirting with a nurse today in the clinic.

He called his wife in from the waiting room with her other miracle grandson, who had also undergone heart surgery. She didn't recognize me at first. I told her not to worry because the first time I had been in her house things were crazy as we were busy with a resuscitation. She almost fell over in disbelief. It was amazing to see her again. I told them that their grandson would now be my patient for many years to come and that I will personally make sure that he has a crisp clear voice. I fully intend to dance at his wedding the same way his grandfather danced at my wedding.

As I said before, once in a while it's really worthwhile to go to work. You never know who you just might bump into.


Jay Wohlgelernter

October 31, 2012

Israelis run Summer Camp in Ethiopia

Information Source - Samantha Friedman, Senior Associate, Rabinowitz/Dorf Communications

Project T.E.N. (Tikkun Empowerment Network) is a project of  The Jewish Agency for Israel.  It provides young Jewish people in their 20’s and 30’s the opportunity to spend a significant length of time engaging in social activism abroad (e.g. Ethiopia), while simultaneously developing their Jewish identities and connections to one another.

T.E.N. has opened a summer camp for street children in Gondar, Ethiopia. They reached the children through a local NGO, Yenege Tesfa, which means, “hope for tomorrow,” and which seeks to care for Gondar’s children by bringing them a home, a family, an education, good health and a future.

The summer camp, named "Bright Hope Camp", is run by a team of five Israeli T.E.N. volunteers and four other volunteer students from the University of Gondar.  51 children who live in the Yenege Tesfa shelters are attending the camp, where they study English every day and participate in traditional camping activities including sports, arts and crafts, and drama activities. Once a week, the day is dedicated to an important topic such as the environment or good hygiene. The Salam Armachau School, a local Gondar school, hosts the camp.  The camp is the largest in scope that the children of Yenege Tesfa have ever had the chance to experience.

Hibist, Coordinator at Yenege Tesfa, said, “T.E.N. and its volunteers are role models, they bring together everyone in order to solve the problems, they move things that haven’t moved for a long time. The children at Yenege Tesfa were hurt so many times by adults that they no longer trust them. Their connection with the volunteers is crucial.”

Olemiu, Education and Health Coordinator at the Yenege Tesfa Organization said, “I can see the amazing effort that is born of the volunteers’ devotion and determination. Even when some of them feel sick or tired, as they are not used to the conditions here, they get up anew and continue with our project (the summer camp for the Yenege Tesfa orphans) and they help the children increase their self-confidence and think differently about themselves. They are helping the children to become more aware of their importance of school and of how to protect themselves from abuse. It is an honor to work with these volunteers.”

Mtzlal, T.E.N. Project Coordinator at the Gojo Neighborhood, is an Ethiopian herself: “I’m very excited about what T.E.N. is doing in Gondar. We are really turning around things that have stagnated for years. We have dug a drainage canal for the neighborhood (in time for the rainy season). The municipality thought that we’re just another organization that buys some stuff for people and then leaves, but now they understand that we’re really here for the long run. Also the other projects, such as the Mother Teresa Clinic. The next step is to help people learn how to do things for themselves and earn money.”

Sister Luciana from the Mother Teresa Clinic has been in Ethiopia for 25 years: “The T.E.N. volunteers made an impact very quickly – the need was so great – and they are doing a good job. They are very responsible and have a strong will to succeed. They connect with the children and take care of and feed those suffering from various illnesses.”

Future Jewish Leaders Visit Israel

Jewish teens arrive in Israel for three-week leadership exchange program.
by Samantha Friedman, Rabinowitz/Dorf Communications

SAN FRANCISCO – As part of the selective Diller Teen Fellows 15-month international leadership program, delegations of Jewish teens from six North American communities have arrived in Israel for three weeks this summer.  Organized by Diller Teen Initiatives, a program of the Helen Diller Family Foundation, the Diller Teen Fellows program pairs cohorts of incoming high school juniors from North American communities with cohorts of Israeli students their same age.  This year, 120 North American students are in Israel between July 18 and August 8.  Through educational workshops, weekend retreats and the creation and implementation of social service projects in each partner community throughout the year, the Diller Teen Fellows program empowers participants to be engaged, effective leaders with a strong understanding of their Jewish identity and respect for Jewish pluralism and peoplehood.

“These young teens are our future,” said Helen Diller of the Helen Diller Family Foundation.  “We need to invest in them, show them they can lead us, and empower them to help repair the world.  It fills me with pride to know that these teens will unite under the banner of Jewish peoplehood, learning to guide the next generation in meaningful pursuits during this inspiring trip to Israel.” 

“This is not a typical Israel experience,” said Tal Gale, Diller Teen Fellows Co-Director.  “Our teens are emerging leaders in their own communities who are going to Israel not just to explore their roots, but to continue developing real relationships with their Israeli counterparts.  They have the opportunity to have shared experiences and to see first-hand the successes and challenges of diverse Jewish communities.  As a people of a dispersed existence we must ensure that current and future leaders of the Jewish people choose and have the capability to make decisions and effect change in a global context.”

Liat Cohen Raviv, Co-Director of the program, adds, “In the Diller Teen Fellows Program, exploration of Jewish peoplehood is intentional and pervasive.  Through the acquisition of knowledge and skills, peoplehood experiences and personal connection to the Jewish narrative, teens become active leaders within and beyond this experiment in Jewish peoplehood, providing us insight into our collective future, our future identity.”

This year, six Diller Teen Fellows partnerships are participating in the Israel Summer Seminar:

·         San Francisco/Upper Galilee
·         Baltimore/Ashkelon
·         Los Angeles/Tel Aviv
·         MetroWest New Jersey/Rishon LeZion
·         Montreal/Beer Sheva-Bnei Shimon
·         Pittsburgh/Karmiel-Misgav

During their three-week seminar in Israel, 240 North American and Israeli participants from the 12 communities will come together for the Diller Teen Fellows International Congress from July 27-31.  This international seminar, which focuses on the concept of a global Jewish Peoplehood, is largely facilitated by more than 60 North American and Israeli program graduates participating in follow-up programming which provides them with platforms to put their leadership training into action.  The rest of the time, the fellows will engage with the “real” Israel, focusing on both its beauty and blemishes, in Israeli cultural and exchange activities, as well as gather to celebrate Shabbat and other Jewish religious ceremonies, visit historical sites, hike and experience outdoor activities, volunteer through community service activities chosen and created by the teens themselves, and be hosted by their partner communities.

The staff and lay leaders of the North American and Israeli delegations will convene in the fall in San Francisco for the Diller Teen Fellows’ Professionals’ and Lay Leaders’ Conference, a gathering bringing together North American and Israeli program leaders from 18 communities.  Delegates will participate in professional development activities, deepen their cross-cultural partnership, and explore the relationships between Jewish communities in Israel and abroad.  In addition to the 12 communities participating in the Israel Summer Seminar, the following additional partnerships will take part in the fall conference:

·         Boston/Haifa
·         Toronto/Eilat-Eilot
·         New York/Ramat HaSharon

The Diller Teen Fellows program was established in 1997 by San Francisco philanthropist Helen Diller.  More information is available at http://www.jewishfed.org/diller/fellows.

Nazareth Hospital Conference

The Nazareth conference was held recently to celebrate 150 years since a tiny dispensary was established in Nazareth by a devout Scottish couple, Dr. Kaloost Varden and his wife. The hospital was then officially adopted by the Church of Scotland and today it is the Israel Government Hospital for Nazareth, still supported from Scotland.

Irene Murray was the head midwife there for many years and through the work of Wendy Blumfield as a childbirth educator, they all became good friends. Workshops were given which were attended by Arab and Jewish midwives and Tipat Halav (child welfare clinic) nurses from the kibbutzim and villages around as well as from the Nazareth hospitals.

 

The conference workshop was given by another British midwife, Kathryn Gutteridge, on the subject of helping women in childbirth after a history of sexual abuse, a problem that applies to every culture.

L to R Irene Murray (former head midwife), 

Wendy Blumfield (childbirth educator) and 

R. Miriam Shibli current head midwifery tutor.

In the audience were midwives, social workers, childbirth educators and doulas, Arab Moslem and Christian, Jewish secular and religious. Many of them knew each other, hugged on meeting and chatted so much it was difficult to keep the coffee breaks to the allotted time.

The foreign media should witness these multi-cultural peaceful events.  

Technion Babies - Israel's Scientists of the Future

There is probably no other country in the world where one would see so many pregnant students on campus.  But in Israel, youngsters, male and female complete army service before starting university and by the time they are studying for their postgraduate courses many of them are married and starting a family.

The Technion Institute for Science and Technology in Haifa is aware of this and raise funds to build beautiful family-sized dormitories for their married students. And on campus one will see many young parents with babies carried in a sling or wheeled in a stroller.

But unique even in Israel is the childbirth preparation course and lactation support system run by UK-trained active birth teacher, Wendy Blumfield in the framework of the Students Union. Starting every two months, a new group is opened for couples in small groups, meeting in a convenient location on campus and at a subsidized cost.  After the births, the group meets again with the co-ordinator to admire each other’s babies and recount their birth experiences.