Good Care Anywhere
November 25, 2011The following article appeared in the December 2011 issue of Gastroenterology and Endoscopy News.
Good Care Anywhere
by Mark Fleisher, M.D.
Vacations are supposed to be about relaxation and rejuvenation. Sometimes they’re even about education. I knew it was time for a vacation. I could use a euphemism, but in all honesty I was just becoming plain old crabby. It was time to take a trip. I contacted my friends at touringisrael.com, and off we went. As a graduate of the Sackler School of Medicine of Tel Aviv University, I can say that I’ve lived in Israel. However, that was 20 years ago, and even when I lived there I basically saw nothing. Immersed in school, I learned my subjects but only years later did I learn my lesson. Real lessons. Not whether this muscle inserts here or there, not what is a Golgi apparatus. Real lessons that come with the most important aspect of medicine: observation. We see a patient at one locus in time and we have no idea of his or her fate. But when we watch them and observe them, we start to plot a course. It is akin to sitting in the chair at the optometrist: better, worse or the same. My internal barometer told me to go on vacation so I could get better.
The first five days were amazing. Ibex in the desert. Eating caper shrubs. Walking through dry wadis. Lunching on hummus stuffed in pita with Bedouins. I certainly never did this while in medical school, and yet this was quite an education. As Friday night cooled the region, our tour guide Joe took us to his home for Shabbat dinner. We met his wife and three children. Hosted by his in-laws, Sarah and Felix, we were the honored guests. From Tunisia, they spoke French and Hebrew. Being from Brooklyn, I barely speak English. Despite having gone to school in Tel Aviv, I never learned Hebrew. An opportunity lost. I may know an endoplasmic reticulum, but I can’t communicate with an entire nation despite having spent four years there. Perhaps I never lived in Israel; I merely sojourned there, like the Jews in Egypt in Exodus. As Felix doled out heaping portions of Sarah’s creations, I was able to learn about him. He came here penniless. He was given the name Willie, in honor of the Nazi soldier who spared his father’s life. The Nazi soldier who said he was sorry. He was awarded the highest honor from the president of France for helping French and Tunisian expatriates to resettle in Israel. He was a seemingly simple elderly man, ladling out Sarah’s couscous. Yet, he was teaching us important lessons: humility, charity, memory. That was quite a dinner.
The next day about two miles south of Nazareth, I fell off my mountain bike. With a fractured clavicle and a few broken ribs, I was brought to the nearest hospital in Afula, a speck on the map. My arm dangling, my legs bleeding and my head covered in thorns, the triage nurse asked, “From Nazareth?” I sure looked the part. I was whisked right in. So there I was, a Manhattan-trained gastroenterologist in the middle of nowhere doing my best Humpty Dumpty imitation.
One thing I knew: I knew I would get good care. I live in Jacksonville, and whenever someone from New York City or Los Angeles or Chicago is admitted, I can read their xenophobic fear: Will I get good care? As if only traffic jams and smog will allow good care to be rendered. I had no such fear. I know wherever I go, doctors and nurses and technicians and transporters are universally going to strive to give good care. Maybe the equipment is not the newest, maybe the floors aren’t the shiniest, but the people always do their best. Worldwide, people in medicine always do the best they can. By my definition, that’s good care.
The waiting room was half Arab, half Jewish. So was the staff. All in the same boat, each tacitly agreeing who should go first based on how bad the other looked. As I lay quietly, the nurse wheeled my bed over to the nurses’ station. She handed me the phone. “For me? I don’t know anyone,” I thought. It was the head of the hospital who wanted to know if I was OK. He wanted to know if I was getting good care. He wanted me to know that he was available if I needed anything. He told me that he was a friend of Felix.
Later, I was wheeled over for three more phone calls. An orthopedist came in to look at my films—on the Sabbath, during a doctors’ strike. I got good care. But I have a feeling that the orthopedist would come in because that’s what they do. I know that everyone else was getting the best care available. They just didn’t get wheeled to the nurses’ station to speak on the phone with people whose names tend to be on letterheads.
After I was discharged, I spent the next few days in our hotel while our boys did more hiking and swimming and rappelling. With me out of the way, they probably had a better time. But you could see the concern in their eyes. Fear and relief is a strange brew. Little did I know that Joe, our tour guide, my friend, was calling every hour to check on me. So did his wife. So did Felix. My wife doted on me but that’s nothing new; she always does.
As I got better, I learned a great lesson. The best part of life is the relationships you form. One thing I didn’t need to learn: I knew I got good care.
