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:)
