holocaust memorial day

holocaust memorial day is a big deal in israel. a two minute siren sounds at 11:00 am, and the entire country comes to a complete standstill. all the traffic on the freeways stops, and drivers get out and stand beside their vehicles solemnly. the siren is a constant pitch, differentiating it from the sinusoidal siren used to warn of incoming rockets. this year some friends and i went onto the roof of our hospital in advance to watch the normally bustling world around us pause. it really is quite poignant for an entire nation to stop what it is doing and remember something which has had such a major impact on its people; on the world. a foreigner such as myself can’t begin to understand how important the memory of the holocaust is to the psyche of this country. when foreign dignitaries visit, their first required official stop is always the evocative yad vashem, the holocaust museum in jerusalem. while one can assert that current israeli political leaders unfairly use the memory of the holocaust to attempt to justify their hawkish and intransigent stances, there can be no debate that israel has served as an oasis and a “coming home” for millions of jews who understandably wanted self-determination after the holocaust. despite israel’s faults, that is a beautiful thing.

one of my medical school colleagues organized an evening talk with an english speaking holocaust survivor. her name was chaya, and she was a small child in poland when world war ii began. her jewish parents realized things weren’t looking good for her as a jew, so they gave her to another non-jewish couple to raise her as their own. during the war she had no idea she was jewish. she told us of witnessing some terrible atrocities including the merciless murder of children. torward the end of the war suspicion began to mount that she was indeed jewish, and the nazis came to murder her; she escaped only thanks to her “chutzpah.” after the war, her mother, the only family member who had survived, came to reclaim her. her adoptive family didn’t want to give her up, so her mother had to go to court and pay a large sum to legally regain custody, a cash cow for the government at the time. apparently there were huge numbers of jewish children being raised by adoptive parents. it was quite the story. she then moved to america, and eventually made aliyah (immigrated to israel) as a senior citizen. it is extra powerful hearing these stories from the very mouth of someone who lived it. soon this won’t be possible any more, so i felt very privileged to be able to hear from chaya. may we never forget.

weekend in nazareth

i went up to nazareth the other weekend for a get together of international christian students in israel. it was a great time. nazareth is the largest arab city in israel, and and the hometown of Jesus. though the arabs of nazareth are full citizens of israel, sadly the population is very segregated. the almost entirely jewish city of nazareth illit is situated at the crest of a semicircular hill that surrounds the arab city, much like the settlements in the west bank. debates over the allocation of water, the building of bomb shelters, where the busses stop etc are common. nothing illegal or as charged as in the west bank, but it is sad that there isn’t more appetite for integration between arabs and jews within israel proper.  

we went up and had a delicious dinner of chicken at a local restaurant on thursday evening, then stayed in an atmospheric ottoman era mansion-turned hostel in the old city called fauzi azar. while there i ran into a random friend from college! on friday morning we visited the church of the annunciation, the main sight in nazarath, which marks the spot where mary learned of the impending birth of Jesus. interestingly, various artists representing numerous countries around the world were commissioned to create artwork depicting mary and the Christ child: these culturally disparate visualizations are positioned around the church and the courtyard. there are many other less famous churches, monasteries and mosques sprinkled around the city as well. we then visited nazareth village, a replica/reenactment of first-century nazareth. though it sounds childish, it was actually very well done, and our guide had many an explanation of Jesus’ various parables and how they would have been interpreted in the context and customs of the time. i really enjoyed it. then i climbed a huge hill for a view over the city before attempting to return to beer sheva, which was complicated by the fact that shabbat was looming so the buses had already stopped. managed to get home via three sherut (shared-taxi) rides and eight hours later. nice weekend!

match result!

"match day" - the most infamous day in a medical student's life - was in march, and in june i'll be moving to philadelphia, pennsylvania for the next three years! for those who don’t know, the match is a computer algorithm that correlates the rank lists of applicants and residency programs. the process starts with applications, and then (hopefully) interview invitations to specific residency programs in the fall, which one then ranks in order of preference. on match day, every residency applicant finds out at the same time via email where they matched for residency. the mathematicians who developed the algorithm won a nobel prize for their efforts! it usually works out for the aggregate best, but there are never any guarantees that one will end up at somewhere near the top of their list or of matching at all for that matter.

i am absolutely thrilled that i will be doing my residency in pediatrics at my first choice, st. christopher's hospital for children, which is the pediatric teaching hospital for drexel and temple universities. the hospital is in north philadelphia, in the heart of the "poorest zipcode in america." the patient population is predominantly african american and very underserved, which is tremendously attractive to me, as on the whole i will much prefer the inner-city to dealing with upper-middle class suburban anti-vaxxers. also thrilled to get to move to the great city of philadelphia! it is a better residency program than i deserve objectively speaking and i am so very thankful to God for this opportunity! all are most welcome to come visit!

geriatrics: never again

i’m back in israel. the last few months of medical school we’ll be doing four “selectives,” each being two week sections in different subspecialties. my first was geriatrics, which thankfully i will never again have much to do with in my life professionally. still good to know about on a personal level i suppose. the first week was in beer sheva, but the second week we were relocated to a wine-growing paradise between tel aviv and haifa called zichron yaakov! and the school payed for four of us to stay in a nice hotel! (that’s definitely the most generous thing my medical school has ever done for us). we were at israel’s largest geriatric facility, and got some great teaching. the israeli healthcare system is extremely well integrated and it is very impressive to witness the spectrum of the various levels of care within a multidisciplinary facility with the broad mandate of caring for the elderly.

an intertesting sequela of israel’s status as a jewish state is how much say rabbis have when it comes to healthcare law. at the geriatrics hospital there was an entire building devoted to mechanical ventilation. in the rest of the developed world, people might be placed on a ventilator at the end of life, but if they are deemed to have lost brain function and the family agrees then they will typically be disconnected with little ethical equivocation. in israel however, once someone is intubated and placed on a ventilator, it is illegal to disconnect them for any reason if doing so would lead to respiratory distress, regardless of the patient’s prior wishes or the those of the legal proxy (also irrespective of the patient’s religion, despite this being an esoteric religious intricacy rather unique to judaism). what this means practically is that many elderly – basically just bodies – in vegetative states with no likelihood of a return to consciousness are kept alive on mechanical ventilators for indefinite periods of time. literally, this only happens in israel. an entire building of long-past brain dead elderly on mechanical ventilators, at tremendous cost to the state, for no reason other than that the rabbis say it should be so. this after watching otherwise healthy toddlers die preventable deaths in the philippines because the hospital doesn’t have any ventilators. i find it fascinating how this specific contrast could literally not be starker between any two other countries in the world.

the best part of the week was an inclusive breakfast at the hotel, with 30 types of cheese and made to order americanos on demand! my friend kady and i averaged about five americanos each every morning. also spent some good time in the hotel’s hot tub (a true rarity in israel)! we had a day off for the israeli elections, and a number of my classmates came up for some wine tasting organized by my friend jenna. we went to two unique wineries in the area, israel’s wine heartland. also patronized a super-gourmet restaurant called uri buri’s in the seaside town of akko – i would never spend that much on a meal unless ladies made me do it but i must admit it was a gastronomic pleasure pit! it was match week so we deserved it:)