Israel 43,

Hi Everyone,

Yesterday and today were about the same so I will combine them into 1 dissertation. I had an evening shift on Monday, 3:00 to 11:00 finishing at 12:00 and returning to the hotel at 12:30 and a morning shift today, Tuesday from 7:00 to 3:00 returning home at 5:30. Long days with little time to recuperate between shifts. Tomorrow I will sleep in as I only begin at 3:00. I am at a new restaurant on the beach for dinner and a beer with enough time to write my blog and keep you up to date with my work.

I worked in Bat Yam last evening and in Richon Lezion for the day shift today after 5.5 hours of sleep. Both teams as usual were delightful to work with. Quick, efficient, pleasant, respectful to the patient, I can never say enough superlatives. I hope that they have the same comments about me.

1 case was a 48 year old male with severe chest pain, profuse sweating, pain irradiating to the arms and jaw, an obvious MI. We had to work quickly as time was of the essence if we were to get him to the hospital on time. Usually we have a driver, an experienced P-M, a junior P-M and me. In this case we lacked the junior so I had do both act as the physician and the junior P-M. We did the usual, history, physical, IV, EKG, oximeter. We then quickly gave, oxygen, ASA, heparin, and a pain medication. The patient started to improve immediately. We raced to the hospital with sirens blazing. The complication could easily have been ventricular fibrillation , asystoly and cardiac arrest. The P-M emailed the EKG to the hospital which showed a Q wave, an elevated ST segment and a reversed T wave, an obvious acute MI. The medical team including a cardiologist were waiting for us in the medical ICU in the ER. A cardiac echo was done immediately and after exchanging the monitoring, the patient was whisked to the cat (catheterization) lab for an angio and stent or bypass if necessary. We saved him with a rapid diagnosis and immediate institution of the appropriate treatment with no waste of time which could have cost the patient his life. Amazing!!!

For the 2nd case we were dispatched to a poor area of town. We had to carry our equipment up 4 flights of stairs as there was no elevator. The P-Ms kept asking me if I was OK. The patient was a 40 year old female, schizophrenic, who had tried to ‘jump out of the window’. The P-M spoke quietly to the patent, calmed her down, gave her a sedative and spoke with a psychiatrist by phone, By that time things had cooled down and as the patient was no longer in acute distress we decided to leave her in the company of her mother. Here is the sad part of the story. On the wall was a lovely picture of the patient’s mother, who was present, in her beautiful white wedding dress with her handsome husband standing in front of a nice new white car. Also on the wall was a picture of the whole family with their 5 young children. In the bed room was the husband in bed with a wheel chair bedside the bed. He had obviously had a stroke and could barely move or talk. On the couch was another daughter with obvious mental problems. Another picture showed a son with a grandchild who seemed to be doing well. We spoke to the mother at length who with social services was coping the best that she could. With this on her shoulders, I don’t know how she gets up every morning to face the day.

Another case today was a 45 year old woman who threw herself on the railway tracks in an attempted suicide. The conductor of the train saw the woman and was able to stop the train in time before running over her. The police were called and took her off the tracks. When we arrived, things were quite stable. The P-M spoke to the patient at length. She was not married but had 1 child and was known to be depressive. The P-M called the psychiatrist for instructions. In these cases, as there is a risk to the patient, we are authorized to give the patient a strong sedative and to take the patient by force with the police if necessary. With the P-Ms support by talking gently to the patient, we were able to convince her to come with us to a psychiatric institute where she is known and where she could have proper treatment.

Just another day in paradise…..as the song goes.

Love,

Brian

The hospital where Rabin was taken to after he was shot and where he passed away

On the beach at a restaurant at night in Tel Aviv

Israel 42,

April 29, 2024,

Hi Everyone,

I am sending the following article to you because the author has responded on paper what I truly believe to be true. I would welcome your comments. 80% of countries that belong to the UN do not have legitimate votes in their own countries. But at the UN, they come and ‘vote’ as a bloc against Israel the only true democracy in the Middle East. I will put this on my blog for all of my followers to read. 

Today I saw videos of tents being put up on the McGill campus, my alma mater, where I am currently a Clinical Lecturer. What does trespassing on private property mean in Canada? The students who are protesting, except for their cries of ‘free Palestine’ would be tied to a pole and whipped if they ever made their ‘woke’ points of view public in a Free Palestine with a Hamas government or in any other Middle East country for that matter. Look at what they have done to women in Iran who rebelled against the religious authorities. Where are the world wide demonstrations against Iran?

Quora

The problem with Antonio Guterres’ statements is that they are deepities.

The term “deepity” was popularized by American philosopher Daniel Dennett, who described it as a statement that sounds thoughtful and profound to someone with a shallow mind, but is in fact trivial and either meaningless or false.

Take, for instance, Guterres’ comment that Hamas’ pogrom did not take place in a vacuum. This is a textbook example of a “deepity”. The carnage Hamas inflicted on Israeli civilians didn’t take place in a vacuum? Really? No shit, Sherlock! Nothing takes place in a vacuum. The founding of the modern nation of Israel didn’t happen in a vacuum. Israel’s stance towards its neighbors and other countries in the Middle East didn’t occur in a vacuum. The Holocaust didn’t happen in a vacuum. World War II didn’t happen in a vacuum. World War I didn’t happen in a vacuum. The bombing of Hiroshima and Nagasaki didn’t happen in a vacuum. The French Revolution didn’t happen in a vacuum. Every event in human history has a context. Every serial killer, every gore-soaked monster has an origin story full of moral ambiguity and heartbreak. Nothing under the sun — nothing under any star in the cosmos — happens without a reason. Cause-and-effect is one of the most fundamental realities of the universe.

So to begin with, the statement that what Hamas did, it didn’t do it in a vacuum, is breathtakingly trite.

Beyond that, what it insinuates is false. One insinuation is that Hamas and its fighters have no agency, because of the historical context — while Israel doeshave agency, no matter the historical context. But why? Why does “no vacuum” means “these people are not fully responsible for their actions” in one case, but “you can’t do “x” to defend yourself no matter what the circumstances are” in another? The implication that Hamas is not fully responsible for its actions is false, and also insincere because of the double standard applied here.

It also implies that whatever Israel did wrong is fully responsible for the rise of Hamas and its ideology. No responsibility is placed on Islamic extremism or antisemitism. No responsibility is placed on Russia’s age-old machinations in the region, either. Rather, it is insinuated that to the extent Islamic extremism and antisemitism exist, Jews are to blame for them for not being 100% morally pure to a man at all times. This is the same argument that was used to rationalize the Final Solution.

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You want to talk about things not occurring in a vacuum?

Let’s talk about the actions of the Soviet Army as it marched through Germany and later occupied parts of Germany at the end of World War II.

To begin with, nothing Palestinians ever suffered can even remotely compare to what the citizens of the Soviet Union went through in the context of the Nazi invasion of their country. In addition to the outright extermination of Jews and Gypsies, the Nazis considered the “Slavs” to be subhuman and brutalized them without regard for civilian life. As a result, the Soviet Union experienced carnage on a scale the world had not seen since Genghis Khan conquered China back in the12th century.

As the tide of the war turned, and Soviet soldiers began marching westwards, they had to pass through what was left of their country. They passed through flattened cities, burned villages and barren fields. They passed rotting corpses and saw charred bodies of children and old people. They saw barely covered mass graves. They saw mutilated and defiled bodies of women and girls. In addition, most of those soldiers had lost friends and close family to the war. Many had lost their entire families.

And then they arrived in Germany.

You probably know what happened next. I just want to make sure you realized it didn’t happen in a vacuum.

And you know what the curious thing is? Apart from a couple of extreme Russian apologists, I don’t think I’ve ever heard — and I certainly haven’t seen on Quora — anyone rationalizing or defending Russian atrocities in Germany as something that “didn’t occur in a vacuum”. Where be the rousing voices defending the mass rapes and the beatings and the murders as an understandable reaction to extreme psychological trauma, never mind a valid liberation technique? Where are all those lovers of freedom and humanity, who believe we simply can’t judge someone who’s ever experienced aerial bombardment, no matter what they do?

From what I gather — and believe me, I’ve scrutinized the profiles and the feeds of many, many pro-Hamas commenters here — the same people who act as apologists for the torture, murder and kidnapping of Israeli and Jewish civilians, including small children, also believe there is absolutely no justification for what the Soviets did in Germany.

What is the difference, I wonder?

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Guterres’ statement that Israel has to follow international law is another deepity.

EVERYONE has an obligation to follow international law. His comment is technically true, and also meaningless.

It also implies something false. International law does not ban military retaliation for an attack. International law does not prohibit civilian casualties, as long as civilians are not targeted and reasonable — reasonable — steps are taken to minimize those casualties. International law does not require a country that’s at war with another to supply food, medicine, water and materiel to the enemy. International law does not mandate that two countries at war suffer comparable civilian casualties.

Is it possible the Secretary General of the UN doesn’t know diddly squat about international law?? Well, hell, we live in a world where nothing matters anymore, so sure, why not.

That he is an ignorant, uninformed, superficial moron, and that all his numerous aides, researchers and advisers are also ignorant, uninformed, superficial morons, is actually the most charitable interpretation of his comments.

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Housekeeping note: I am keeping the comment section open for now, but I will not dignify any antisemitic or pro-Hamas (but I repeat myself) comment with a response. I will delete it immediately and block and mute its author, as well as the author’s tens of followers and anyone who’s ever upvoted any of their antisemitic posts. Yes, I am doing “block bans”, because I’ve had it with the antisemites these past couple of weeks. If you lean that way, we have nothing to talk about, and I am fine with us not having any kind of a dialogue, ever.

UPDATE: Comments closed. Maybe temporarily, maybe not.

Israel 42,

April 28, 2024,

Hi Everyone,

I was off on Friday and Saturday. The weather was perfect for touring. On Friday, I drove up the coast and on Saturday I walked around Tel Aviv.

I decided to visit a neighbourhood called Neve Tsedek. N-T is an older area where the houses are about 100 years old. The streets are very twisting, narrow and often cobblestoned. Most of the area has been renovated and gentrified. There are single homes but mostly row housing. The homes that have been updated are beautiful and I am sure very expensive The area is not far from the beach. There are many high quality shops and restaurants. I had a capuccino and a frozen yoghurt decorated with fruits and chocolate sauce.

Later in the afternoon, the sun came out and so did the heat so I did some body surfing.

You can see from the pictures the contrasts that are apparent in the city. There are high rise apartments, houses that have not yet been renovated, gentrified streets and mansions. There is always something to discover in the city that they call ‘the city that never sleeps’.

I spent the day today in the ambulance. The cases were very routine. Tomorrow I will do an evening shift, leaving me the morning to catch up on my emails. As usual, I am sipping a beer, finishing off my first pizza in Israel and writing my blog.

Love,

Brian

Israel 41,

April 27, 2024

Hi Everyone,

Yesterday was somewhat cool with temperatures in the mid 20s and cloudy so I decided to do some touring by car. I took towels and a bathing suit just in case, but the weather was really not nice enough for my usual swim in the Med. I drove to Natanya a medium size city north of Tel Aviv. The city seems nice to live in but less interesting to visit than Tel Aviv. There is a central market place/plaza with stores and restaurants which I drove around but didn’t stop as I could not find a parking spot. I then drove along the coast to observe the beach. The beach is at the bottom of a cliff that has a beautiful point of view. You could either park for free and walk down, which was quite a hike or drive down and pay for parking. I chose the later but drove through the parking lot to get a good view of the beach. It was windy so there were a lot of surfers out. I love to watch surfers. It seems like a sport that I should try once, with lessons of course, before I get too old to do these activities.

I then drove to a Caesarea, another town north of Natanya. Israel is a tiny country so the distances from one place to another are not far. All of the land in between the towns is exploited one way or another with agriculture or industry. They don’t have the endless forests here like in Canada. You can’t really get lost as you can always see civilization. Caesarea, as the name implies was built by the Romans. Herod the king got a bad rap in the bible for certain deeds. However, he was quite the builder. Masada was built by him as a summer palace. After the Romans, there were numerous conquests by the Arabs, the Crusaders and the Ottomans to name a few. The city was an important port and has an aqueduct. The ruins, as the name implies were quite ruined. However some vestiges remain which are worth seeing. To top things off and to enjoy the view, I had a capuccino and a gelato.

I then drove to Herzliya which is another town just north of Tel Aviv. The town is very pretty with numerous parks. There is a lot of wealth here and the houses in the town are grandiose. Unlike North America where the front lawn is very important, these houses as in much of Europe are protected by high walls making viewing somewhat difficult.

Last evening I was invited to Vickie’s for a Passover Shabbat dinner. Vickie was very influential in getting me my place with MDA. Vickie is originally from Turkey but made Aliyah many years ago. She always invites young students to her house when I am invited. Yesterday I made the acquaintance of 2 young fellows from Turkey who were spending several months here learning Hebrew and doing internships in their respective fields of interest. It was interesting talking to them about their lives as Jews in Turkey. Turkey is a Muslim country which has had a checkered relationship with Israel. I must say that having lived in Canada for 74 years, up until Oct 7, I have never directly or indirectly had an antisemitism incident towards me. The 2 fellows gave me the impression that as Jews, they had to be cautious living in Turkey. Outward displays of Judaism would not be dangerous but could possibly not be welcome. Seeing the demonstrations in Canada, the US and Europe, I can only hope that we are not moving towards this problem.

Love,

Brian

Natanya

Caesarea

Herzliya

Tel Aviv suburb

Israel 40,

April 26, 2024,

Hi Everyone,

I wrote my last blog sitting on the beach late in the evening. I am now writing this blog while sitting at a cafe, sipping a capuccino and waiting for my laundry to complete its cycle at the laundromat. It reminds me of my days as a medical student in Reims, minus the iPad of course.

I was asked to do a double shift yesterday in exchange for 2 days off. It seemed like a good deal. I was up at 5:30, had a light breakfast and drove to my MDA station to start at 6:45. I actually worked at 2 stations, beginning my second shift in the afternoon and finishing at 11:15, returning to my hotel at midnight. I needed to relax a little so I had a salad and beer at my favourite bar/cafe/restaurant on the beach while doing emails.

Both shifts were rather routine as sometimes occurs and which I have described on previous blog entries. On the last shift I worked with 3 young ladies. As usual, I was impressed by their professionalism, kindness to the patient, speed and efficiency. The P-Ms have 2 years of intensive training and are very well prepared for all emergencies with appropriate protocols and back up with higher authorities if they need on the spot advice. I try to add any medical advice and approval of medical decisions when asked for my opinion. They seem to like to have a physician on board for back up when necessary.

We had 1 case which could have been a disaster but which turned out well for the patient. She was really lucky to survive and should go out and buy a lottery ticket as ‘Lady Luck’ is definitely on her side. She was driving on the highway at 100K when she lost control of her car. The car went off the road and jumped a 3 meter high group of shrubs. it was lucky that the car did not hit a tree as it would have split the car in two. Instead the shrubs slowed down the car and saved her life. The car was destroyed. We had to get the fire department to extricate her from the vehicle. We took the usual precautions, back board, neck brace, IV line etc and got her out through the back window. We got her to a trauma center and ran her through a number of blood tests, x-rays and CT scans. Other than being seriously scared , and a few minor bruises, she was totally unscathed by the accident. She was very, very lucky.

Love,

Brian

Israel 39,

April 26, 2024,

Hi Everyone,

Here are the pictures corresponding to my last blog entry.

Love,

Brian

Hospital

Military

rehab center

Israel 38,

April 24, 2024,

Hi Everyone,

I just finished an 11 hour shift and I was just asked to do a double shift for tomorrow. I think that they are short physicians to work on the ambulances. I have been here for 10 days with MDA and I think that I am beginning to get reasonably well known among the P-Ms who may be asking for me. Tomorrow, I will be up at 5:10 to leave at 6:00 arrive at the MDA station at 6:45 and do a double shift until 11:00. It is almost like I am back at the RVH as a resident. Anyway the P-Ms are very nice to work with and the work is exciting as you can see for yourselves in my blog.

I am sitting out at a restaurant on the beach in Tel Aviv. I am at a low table on the sand with my legs stretched out under the table. I think that I ate here with Dominique 10 years ago. It is pitch black, with no stars out this evening. It must be 25K with a slight breeze, to cool things off as it hit 37K today. The restaurant speakers are playing American/Israeli modern music, not too loud, just nice enough to enjoy the evening. The boardwalk is packed with people strolling along. People are still playing volleyball on the sand.

I am getting used to the types of call that we receive. Elderly people with chest pain, shortness of breath, stroke, not feeling well with no obvious signs, car accidents. We take a history, do a routine physical, do an EKG, test for glucose, put on a monitor and oximeter and BP cuff, start an IV and then transport to the hospital at the speed necessary depending upon the urgency.

One child swallowed a big candy that probably got stuck in his throat and then passed. We reassured the mother and took the child to the hospital for observation. One 40 year old man had right upper quadrant pain referred to the right flank or perhaps the other way around. He had a low grade fever. We gave him an IV analgesic and the pain went away. He decided not to go to the hospital and was ready to sign a release. When I got the translation, I told him that he needed to come with us for an ultrasound as he either had a gall stone or perhaps a kidney stone and the pain would return in 2 hours. He asked me how sure I was and I answered 100% sure. I guess that my white hair convinced him. He came with us to the hospital. The P-Ms were impressed with my ability to convince him to come for investigation and treatment.

The last patient was a motorcycle accident. My shift had ended but I wanted to go anyways. The fellow was riding a Kawasaki 750 and slid on the pavement. He was wearing a helmet, shorts and a t-shirt. That is the standard dress here for motorcyclists. He had a bad burn on his arms and legs, what we call road rash. He was lucky not to have broken anything. We took him to the hospital for a clean up. I told him that I have had a bike for 50 years and that he should be wearing leather or goretex. Maybe I made an impression on him.

I have visited several hospitols including Tal Eshalon which is ranked 9th best in the world. Very, very impressive especially for a tiny country like Israel. We also picked up a patient from a nursing home/palliative care/rehabilitation center. Wow. I never saw anything like it. It resembled a 5* hotel on hospital on steroids. And this was a public institution! We are really far behind in Canada and have a lot to learn from the Israelis and their standard of care.

I just finished a plate of mergaieze with veggies and a beer. I am listening to Marvin Gaye, the temperature is just right, my mouth is burning from the spice so I will treat myself to another beer, and an apple crumble with ice cream. Why not, I ate virtually nothing today, need to re-vitalize for tomorrow.

Love,

Brian

I will put in the pictures tomorrow or on Friday

Israel 37,

April 23, 2024,

Hi Everyone,

Last evening I spent the Passover Seder with Rochelle and her charming family. Passover is usually a happy time for Jews but this year our happiness is subdued due to the ongoing war, the failure of the return of the hostages after 6 months and the problems which we who live in the diaspora are enduring. I never thought that at 74 years of age that I would be volunteering to go to war. Nor did I ever believe that I would witness the antisemitism that we are witnessing in Canada and all over the world. Who are our friends? Who will stand up for us? How have we let these vicious antisemites into our country and why is our prime minister not doing anything? Don’t worry, Mr. JT, an election is coming and there will be a ‘reglement de comptes’. I like the French expression better. What kind of nonsense are they teaching at the universities? How are the students of today so poorly informed about history? At many Passover Seders, a place setting was left empty in memory of the hostages.

Today, being a holiday in Israel, things were very quiet with MDA. I worked a morning shift at the town of Lod. At one point we raced at breakneck speed, 150K to get to patient with bradycardia (a slow heart beat of 40/min). Can you see the dichotomy? We brought him to the hospital on time and saved him . He was originally from Holland, was born in 1940 and came to Israel in 1964. He spoke English fluently. He remembers the liberation of Holland when the Canadians came marching in. My father was stationed in Nijmegen during the war for some time before crossing the Rhine into Germany.

Love,

Brian

Israel 36,

April 22, 2024,

Hi Everyone,

I did emails, laundry and blogging that took some time to catch up. Yesterday I did an evening shift, 3:00 to 11:00 in Yevneh where apparently there is a nuclear plant. The town is very pretty with nice new 10 story apartments. I worked with Dan with whom I have been before. I got a phone call from Moshe, the head of MDA who told me that he would like to do a shift with me as he has never seen anyone get so many ‘good’ cases. Last evening was no exception.

We were called to an apartment to see a 3 year old boy who was having seizures. It was a 4 story walk up and we had to bring all our rather heavy resuscitation equipment. The child was having seizures and so of course was not conscious but breathing ok. We gave him a shot of anti seizure medication which slowed things down. The seizures were due to a fever so we cooled him down with a cold towel. We carried him to the ambulance and I held the oxygen mask on his face for 20 minutes. Once again I was impressed with the efficiency of the service and the kindness with which our team spoke to the parents.

Our next case was a truck vs truck accident. We sped to the scene at break neck speed doing 140K, at 10:00 at night dodging traffic. The motorcycle MDA fellow was there as well as the fire department. There was nothing left of the front of the truck. I don’t know how the man survived. He was pinned between the door and the dash board. The fire men inserted a machine that we would call ‘the jaws of life’. It was a large piston, attached to a generator .It pushed the door open and lifted up the dash. The patient was conscious, not in too much pain and was on his cell phone. We put him onto a stretcher and brought him to the hospital. In no time he had multiple IVs, oxygen, blood tests and x-rays, CT scans. I spoke to the orthopaedic surgeon. The patient was lucky as he only had a simple femur fracture that would require a rod. There were no vascular or neurological complications.

I finished my shift at 11:00, drove back to Tel Aviv which took an hour so they did not give me a shift today. I had not eaten supper so I went to a bar on the beach and had fries and a beer. I watched the end to the Barcelona-Real Madrid soccer game. There was a goal with 2 minutes to go making the score 3-2. There was a lot of cheering so I guess the favourite team won. Tonight I will go to Rochelle’s for the Seder. I told MDA that I didn’t want to do an evening shift today as it would probably be my only chance to do a Seder in Israel although I was invited to one 53 years ago with my friend Arnon.

Love,

Brian

Special forces training, running up a sandy hill in 25C

Israel 35,

April 20, 2024,

Hi Everyone,

I worked hard for the last 5 days, hanging on inside of an ambulance, so I decided to take it easy yesterday. I woke up at 8:00, rather late for me, and spent the next few hours catching up on emails and writing my blog. In the early afternoon, I took a walk on the beach for 2 hours. Swimming has been prohibited up until last week. There were signs everywhere but this did not prevent people from going into the water. I would swim out to the breakwater and back, which is a 20 minute swim, on days when the water was calm. On other days, if there were breakers, I would do some body surfing. Yesterday, the life guards were out so the prohibited signs had been removed. Some beaches were black flagged so you could not go in the water there or you would be whistled out. Some beaches are for swimming and others are reserved for surfers, kite surfers and wind surfers. It was blowing 15-18 knots past the breakwater and there were sail boat races. The breakers were coming in, 3-4 feet high. I swam out 100M to where the 16-18 year olds were. They seemed to know the good spots for waves. If you see a wave coming and swim fast, you can catch it just before it breaks. Eventually, it will catch you and break on you. The hard rippling water and thunderous noise as it breaks on you are thrilling.The wave can carry you about 20 feet before it passes over you. It gets to be like a drug, you just have to keep returning for more.

Last evening I was invited to dinner at my cousin Richard’s place in Rehova, 25K from Tel Aviv. We first went to synagogue, a place that I have not been to in 60 years. The service was orthodox, as the women sat separately. There were many English speaking worshipers there from the US and Canada. I recognized many of the hymns and read the English translation. I met Richard’s family for the first time. He came to Israel when he was very young and served in the arm as a tank commander. He has 4 children, 1 of whom is in the army now. Everyone takes the current situation in their stride. This is what living in Israel is all about and you have to just accept it and get on with your daily life.

Love,

Brian