Category: –

2025-03 Israel

Israel 26,

April 16, 2025,

Hi Everyone,

Last evening when my new friend Boris and his wife left, 2 young girls sat down next to me. As usual, I cannot forego striking up a conversation with fellow patrons sitting at the bar. My opening line this time was ‘are you American?’ As they were both speaking English and were clearly not English or Australian, American was a safe bet. 1 young lady was here for a short visit. The other lady came after Oct. 7, and has been here for 1.5 years. She started a website on Facebook called Sword of Iron, Israel Volunteer Opportunities. It is a very successful website and has become the go to website for foreigners looking for opportunities to volunteer in Israel. I consult the site almost everyday and often read about the volunteering experiences of fellow travellers. I told her that I write a blog on a website and have been documenting my stay of 2 months last year and 1 month this year with the IDF and MDA. She was most interested in my experience and took note of my blog site. She also encouraged me to write my blog on her website which I will do ASAP. It may drive more readers to my site as well as helping me in the sale of my soon to be published book. I have decided that the proceeds of the book will go directly to MDA.

This morning as usual I was up at 5:30 am in order to get to my base on time. The hotel prepares me a breakfast to go as they only start serving at 6:30. It takes me 20 minutes to drive to the base but 45 minutes to return due to the heavy Tel Aviv traffic at rush hour. Rush hour here seems to be any time after 9:00 am to 7:30 pm. I worked with 2 paramedics with whom I have worked before on several shifts as well as the chief paramedic who is very experienced and according to his employees, has seen and done everything. They defer to him for his opinion on many cases. The cases were very simple today so I will not go into details.

The 1st case was a Californian lady who married an Israeli and has been living in Tel Aviv for several years. She is a runner and was suffering from a severe acute groin injury. She could not get out of bed due to the severe pain. We gave her an analgesic and muscle relaxant and her condition improved. I think that she has a coxo-femoral inflammation in her hip. I had a similar condition last month and could hardly walk. The radiologist gave me a cortisone shot in the hip joint under ultrasound guidance and I was better in 15 minutes. She will probably have the same treatment.

The 2nd case was an elderly patient with minimal chest pain that quickly improved when we arrived. He didn’t require transportation to the hospital.

The 3rd case was a young man with a cardiac history. He had midline abdominal pain. We brought him to the hospital for an u/s to r/o an aneurysm which was an unlikely diagnosis. I think that he has a semi acute pancreatitis and will have the appropriate tests.

The 4th patient was an elderly gentleman with mild chest pain. In cases of chest pain we always to the routine tests in the apartment and in the ambulance and then transport the patient to the hospital.

Today we finished on time at 3:30. I said good-bye to my colleagues and we took the usual selfies. I invited them to contact me if they ever come to Canada. I promised to take them skiing if they come in the winter or to go sailing on my boat if they come in the summer.

I cannot leave Tel Aviv without making some comments on the Israeli drivers. I actually find the drivers to be quite civilized as long as you follow the rules. They accelerate fast but rarely go more than 10-15 k/h above the speed limit. They are very much respectful if you have the right of way. On the other hand if you don’t have the right of way, forget about making a turn or changing lanes. It is faster to go around the block. Waze is superb here. Without Waze I could never get from A to B. There are too many one way streets and the streets go in circles rather than straight lines. Signalling is theoretical here if you want to change lanes. The horn is a most important part of the car and is used very frequently. I think that most drivers can hit the horn faster than they can hit the gas peddle. There is a green 2 way lane for bicycles, scooters and small motor bicycles. You must not make the mistake or walking in a green lane. They don’t expect you to be there and will give no quarter. They is virtually no J walking like in Montreal. Pedestrians have a green little man on the traffic light allowing them to cross. This very well respected both by cars and pedestrians alike. Pedestrians will stand for several minutes waiting for their turn to cross even if there are no cars in sight. There are also pedestrian cross walks in the middle of the the street with no lights. Cars jam on their brakes if they see a pedestrian showing an indication of wanting to cross. I rented a small Kia for getting around. You must have a small car here as parking is at a premium here and the parking spaces are very small. Israelis can get into much smaller spaces than I would willing to try. I mostly walk here for short distances or take the bus. A young man rolled down his window and asked me if I wanted to sell my car. He was disappointed when I told him that the car was a rental.

I am sitting outside at a table in a sushi restaurant. The sushi is ok but rather expensive for what you get. It is 20C, very pleasant to eat outside. I am alone at a small table writing my blog. As usual on a Wednesday evening, the restaurants are full and I had to visit several ones before getting a table, as many to the tables are already reserved. People really know how to enjoy themselves here.

Love,

Brian

My new MDA 1st responder motorcycle

Tel Aviv

Tel Aviv Hospital

Dizengoff Square, (which is a circle)

My final MDA Team

2025-03 Israel

Israel 25,

April 15, 2025,

Hi Everyone,

Today once again I had a great team with MDA. I had worked with one of the paramedic last week who is in her training period. I had a driver with whom I had worked as well as the chief of the station. It was like a reunion and I was happy to work again with these highly skilled paramedics. I learn something on every shift and this shift was no different.

Our 1st case was a simple elderly lady with an aspiration pneumonia. She was on IV antibiotics at home and was not improving so we transferred her to the hospital.

The 2nd case was much more exciting. We got the message that there had been an explosion in an apartment building. We could see the smoke rising in the air in the distance. We put the siren on and sped to the building at breakneck speed in the city. When we arrived, the firemen with fire trucks had already arrived. The police were there and there were already several ambulances present. This was a very poor area of town with many new immigrants from Africa. The lady was cooking with propane gas and the tank of propane exploded. The entire front of the apartment was blown out on the street. The firehoses were out and the firemen had already entered the building. If there is one job in the world that I would never do, it would be a fireman. I told that to the paramedic who smiled and said that they have to be very brave. In the end, there were 2 persons injured, not too badly and they were taken away in the first ambulance that had arrived.

The 3rd case was a trauma case that was bad, but could have been much worse. We got an alert that a child had been injured by a pipe and had a penetrating chest wound. We put the siren on and sped to the case. We were doing 150 km/hr breaking my previous record of 140 that I filmed last year. I have never gone so fast in an ambulance. I filmed a lot of the journey and will try to put some of it on my blog in the future. I was not wearing my seat belt as the paramedics usually don’t wear one behind the drivers. When we turned a corner I almost flew… When we arrived, the father had picked up the child and placed him in his truck on the front seat. The 11 year old boy was walking in between 2 buildings when a 2 meter rod, 2 cm in diameter had fallen straight down from the 3rd floor. The child penetrating chest wound 2cm in diameter and 2 cm deep in the anterior triangle of the neck above the clavicle. I never saw someone work as fast and as efficiently as the chief. He examined the wound and then covered it with a bandage. He then secured the arm to the chest with a bandage to prevent movement to the upper arm.

In trauma cases, the paramedics must stabilize and move the patient into the ambulance in 10 minutes. The case took 7 minutes and we were off to the hospital. The metal object had penetrated the skin and muscles but not the lung or chest cavity. The clavicle was visible. The child was very lucky. Had the rod struck his head, 4 cm away, the injury would have been fatal. The rod missed the subclavian artery and vein by 1 cm. That probably would have been a fatal injury as he would have bled out. We did not suspect a neurological injury as the child could move his arm. This will require further testing at the hospital. The child was extremely brave. He did not utter a sound of complaint. He will have a CT scan and surgery immediately on arrival at the hospital. The physicians in the ER were waiting for him when we arrived as we can message them in advance of the injury.

The last case was simple fractured or sprained ankle that we transported to the hospital.

I am sitting in a restaurant at the bar, eating supper, drinking beer and writing my blog. Wine in a restaurant in Israel is very expensive so I usually drink beer. I am at Dizengoff Square again at a different restaurant. Dizengoff Square is packed with people even on a Tuesday evening at 10:00 pm. The vibe here is indescribable. I like to sit at the bar when I am alone as often it gives me a chance to talk to my neighbours. I struck up a conversation with a charming couple who were originally from Soviet Union but have lived in New York for 40 years. He was a urologist in Russia but is now a pulmonary specialist after some retraining. His son is a urologist and does robotic surgery. His name is Boris. He laughed when I told him that I was named after my grandfather Boris but my mother refused to call me Boris Morris. Hence the name Brian Morris, very Anglo and dignified.

Love,

Brian

Dizengoff Square

Modern buildings in Tel Aviv

Explosion in a poor area of Tel Aviv

Severe Injury and Sourasky Hospital

My MDA Team

2025-03 Israel

Israel 24,

April 14, 2025,

Hi Everyone,

I finally got enough sleep to face the day properly. My usual 6hr30min progressed to 7hr and I awoke fully refreshed. ⅔ of my team was new to me today. 1 of the paramedics who is in the army and doing her training with me was with me today. She is both lovely and lovely to work with. The chief of staff of the MDA station was the driver today. He is very experienced in his work and a good driver. The chief of the team was another lovely girl who finished her MDA training with the military in Gaza. For a young girl of 21, she has seen a lot of trauma. She would like to go into medicine. She is currently studying for the SAT exam which is an American exam accepted for admission into Israeli medical schools. She is calm, cool and collective which makes her a very professional paramedic to work with. She explained the admission requirements to get into an Israeli medical school. One way is to apply after high school. This is a 7 year course. The student must at one point go into the army for 3 years. The other way which she has chosen, is to do paramedic training and work as a paramedic both with MDA, a civic ambulance service and as a paramedic in the army. The student then has 4 years of medicine to do. There are 7 medical schools in Israel, all of very good quality. I hope that she is successful with her exams as in my opinion she will make a very good physician. I will be working with the 2 young ladies tomorrow. I am happy as they are very proficient in their approach to patients.

We had 3 patients today which were very routine and I will not describe in detail. The 1st patient was an elderly woman who may have had a urinary tract infection, had been prescribed Cipro and was not doing well. She looked dehydrated so we rehydrated her with ringers lactate. She also had a tender abdomen and will require a full work up including a CT scan of her abdomen. She made a remarkable improvement on arrival at the hospital. 2nd patient was weak and had an abnormal EKG in spite of the fact that he had a pacemaker. The 3rd patient was a routine patient with shortness of breath. I have not seen any major trauma since arriving here in Israel.

It is passover and a number of restaurants are closed for the holidays. Some of my usual restaurants were full and I could not get a table without a reservation. It is Monday night and the restaurants are packed. I walked over to Dizengoff Square where there are several restaurants to choose from. I am sitting at a table over looking the square and just had a dish of shrimps accompanied with a beer. Delicious. The night air is cool and comfortable with Israeli rock music in the background.

Love,

Brian

My MDA station and my team,

Sourasky Hospital

Tel Aviv Beach 9:00 pm

2025-03 Israel

Israel 23,

April 13, 2025,

Hi Everyone,

Yesterday was a quiet day. I spent the morning getting caught up on my emails. I like to classify my emails every day or so or the total number becomes unwieldy. I owed a few friends a return email. I then went up on the terrace and studied Hebrew. Progress is slow as usual but I give myself credit for trying. It was too cool for swimming and the beach was virtually empty. The sky was blue with a little breeze, the perfect weather for walking around and visiting Tel Aviv. There are always new neighbourhoods to visit.

There are facebook websites called Sword of Iron and Volunteers for Israel where anyone who is a member can post things. There is a useful amount of information about what is going on in Israel. Often one can find places to volunteer for the day or for a week. A lady made a posting for volunteers who were looking for a seder to attend. All of my relatives here were either going away or were having a seder with their in-laws. I decided to accept the invitation and brought a box of Belgian chocolates. One of the volunteers staying at Maxim’s was also invited so we walked over together, a 10 minute walk.

The seder was fabulous. The lady was originally from Montreal and had been living in Israel for 40 years. She is a professional comedian and travels the country and the world giving performances in English, French and Hebrew, an incredible accomplishment. Her husband was an accountant from London. My friend was from Ottawa and has lived all over the world. There was another lady from Montreal who had a long career with the Canadian government. The last fellow had an NGO that helps new immigrants adapt to Israel, finding them jobs and apartments. All together it was a highly intelectual group. It is rare that I meet people who have travelled and even lived in as many or more countries as me. Except for one person, we were all on the better side of 68, a real group of genuine real live hippies from the 60s. You can imagine the conversation or maybe you can’t.

The seder was brief as planned, even shorter than our seder in Montreal. Boray Pree Hagoffen and the meal began. We started off the evening with an orange wine that resembled a dry port wine followed by main course of brisket, salmon and salad. For desert we had cheese cake. The wine and conversation flowed until after midnight although I had to leave at 10:30 as I had to get up at 5:30 for work. The lady’s husband did all the cooking, a first quality home cooked meal.

This morning after a 3 day break a was back to work with MDA in Ramat Gan. I had a new team that as usual was very competent. The driver was an experienced paramedic who had spent time in Gaza and Lebanon. He carried a pistol which is common for the driver. We go into many different areas of Tel Aviv, rich and poor and we are never sure what we can meet. Although I have never had an incident in 2 years, it is reassuring. Although I am well trained after my 3 days training with Krav Maga, in orderto disarm an assailant with a gun, knife or baton, I would rather not have to put my lack of experience to the test. The chief today on our mission had 8 years experience with MDA and had just finished his medical training as a physician. He is in the process of deciding what specialty that he will do. I tried to convince him to do urology. Rounding off the team was a young girl who is still training to be a paramedic. The chief let her do the initial history and physical exam of the patient. Afterwards he gave her a lot of teaching in the ambulance, reviewing the case.

Our 1st case was an elderly female in the last staged of breast cancer. The physicians had stopped active therapy and she was having palliative care. The paramedics discussed the case at length with the family to get an idea of what they wanted for their mother. In the end we decided to bring the lady to Tel Hashomer for further palliative care.

The 2nd case was an elderly man of Yemenite origin. In 1948 Israel brought 48,000 Yemenite Jews to Israel in an operation called Magic Carpet. These Jews had lived in Yemen for almost 2000 years. However the antisemitism had become untenable after the foundation of the State of Israel in 1948. 800,000 were forced to leave their homes in Arab countries from 1948 to 1950. They had been living in these countries for 1000 years and left in 2 years with no compensation and not a word from the UN. The man didn’t feel well and all of a sudden, without warning vomited ‘coffee grounds’ all over himself and the floor. Coffee grounds often means partially digested blood in the stomach indicative of internal bleeding. The family, consisting of 6 people didn’t bat an eye lash. They just cleaned it up as if nothing had happened. The floors in most Israeli apartments is made of tile for large plaques of marble 75×75 cm making clean up much more simple than had the floor been made of wooded lattes. We transported the patient to the hospital.

The 3rd case was an elderly man with shortness of breath. He had some crackling at the base of his lungs so we diagnosed that he had congestive heart failure. We gave him 40mg of a diuretic, furosamide and transported him to the hospital. On arrival at the hospital, he voided a large amount of urine and felt much better. His shortness of breath had disappeared and his colour was much improved.

The 4th case was an elderly man who apparently had bradycardia, a slow heart beat. When we arrived he had a high blood pressure but no indication of bradycardia. He was in no acute distress and was not short of breath or had chest pain. We spoke to his family MD who will treat him as an outpatient.

I am writing my blog in one of my usual haunts called Mikes Place. They serve comfort food and the place has big screen TVs on the wall. There is football everywhere. It resembles some of the bars that you find in American ski resorts. On certain nights there is live entertainment but not tonight. I just spilled my bear, missing my ipad and cell phone so the waiter kindly offered me a refill.

Love,

Brian

My hippy friends

MDA paramedics and Tel Aviv

Mike’s Place

2025-03 Israel

Israel 22,

April 12, 2025,

Hi Everyone,

Yesterday I went to Richon Letzion, where I met up with my cousin Richard and his friends for a run on the beach. We usually meet up at Golda’s, the famous ice cream shop chain and then come back there after the run for an ice cream or frozen yogurt and a cappuccino. This time we ran for 10 km which I have not done for some time. My usual run is for 5 to 7 km. running time was 1:20 which is not bad for a 75 year old man with white hair. I am scheduled to do the World Championship Triathlon for Canada in Australia in October in the sprint division. If I get ambitious later in the summer, maybe I will try to do an olympic distance triathlon. The weather was perfect for a run, 18C with a breeze that made running rather pleasant.

In the afternoon I did some shopping. I walked to Hostage Square which has not changed much since last year except the posters showed some wear and tear from having been out in the weather for a whole year. I think that it gives you the feeling of how the health of the hostages must be with wear and tear that their bodies have suffered having been in the tunnels for over 500 days. The hostages, when released show obvious signs of weight loss and malnutrition. The Palestinians in Gaza, who according to the media, are on the verge of a humanitarian crisis and starvation since day 1, still appear to be fat and well fed.

I purchased a ‘bring them home’ necklace and pendant for my American friend who had forgotten to get one as a volunteer. He lives in Michigan and I will mail it to him on my return to Montreal as promised. I then walked over to the Asrieli complex and mall. The 3 buildings are very impressive from the outside and probably house offices. The mall was nice but resembles many other malls that I have visited. I purchased 2 boxes of Leonidas Belgian chocolate. I will give one to my cousin Shari and I will bring one to tonight’s seder. I took the bus back to my hotel. I have an Israeli bus and train pass that you can reload with shekels. I have become quite adept at negotiating the bus, train and metro system in Tel Aviv.

Last evening I drove to Shari’s house near Beersheba. It takes 1:20 to drive there on good roads and an autoroute. With Waze, I have no trouble getting around anywhere in Israel. I wonder if the members of BDS still use Waze to get around as Waze is an Israeli company. They probably still use it as they want you to desist from using Israeli products but not themselves. Shari lives on a moshav. A moshav resembles a kibbutz except that the homes are owned by individuals and not the community as in a kibbutz. The major equipment is owned by the community but each individual is responsible for his own produce. We had Shabat dinner with her family and extended family. Shari’s school was devastated last year on Oct. 7 when she lost many friends, former students and students. She says that is very sad to see the empty chairs where her students used to sit. It is an ongoing reminder of what happened on Oct 7 and what the world is doing to forget about in their efforts to ‘Free Palestine’ leaving Hamas in charge again. A ceasefire only means that Israel ceases and Hamas reloads and fires.

I am sitting out on the rooftop terrace writing my blog. The view of the sea is as beautiful as always. Yesterday and today there is a strong wind with 2-3 foot breakers crashing on the beach. It was not warm enough for swimming yesterday but hopefully it will warm up later in the afternoon. There are whitecaps everywhere making me wish that I could go out sailing. While in Jaffa a few days ago, I visited the old port and spoke with a man who was sitting on an older Benateau First, 35 foot sailboat. He lives on his boat most of the time and has an apartment in Beersheba. He goes to Greece sometimes which is a 4 day crossing. My dream life perhaps in another life…

Love,

Brian

Hostage Square, Tel Aviv,

Asrieli Complex and Mall,

The view from the terrace of my hotel on the beach in Tel Aviv

2025-03 Israel

Israel 21,

April 10, 2025,

Hi Everyone,

I woke up to sunny skies but cool weather with a cool breeze. I am getting spoiled as 22C is somewhat chilly for swimming. I decided to do a museum today. I chose the Palmach museum. The Palmach was the precursor to the IDF which became organized when Israel became a state in 1948. I regrouped the Palmach, the original group, the Haganah, the Irgun and the Stern Gang. They did not get along as they had different views as to what Israel should look like.

The British were given the Palestine Mandate which was carved out of the Ottoman Empire which had been defeated in WW1. It was a difficult region to govern as the British had made 2 separate promesses to 2 separate peoples each of whom claimed the land. Eventually the British carved off Transjordan, changed the name to Jordon and gave it to a Hashemite king from Iraq. 80% of the population was Arab Palestinian and 20% Hashemite. This did not matter to the British who were only interested in an expedient solution. There was a lot of in fighting between the Arabs and the Jews. At the time only the Jews called themselves Palestinians. Golda Meir had a Palestinian passport. The Arabs revolted against the British and the revolt was put down in a violent manner. The Arabs did not want Jewish immigration so to please them, the British brought out a white paper limiting severely Jewish Immigration.

The Palmach was organized in 1941 to fight alongside the British against the Nazis. The Jewish Brigade was broken up after the war and was later reorganized into the Palmach. All of the above groups fought against the British to get them to leave Palestine. The Jews worked hard to bring clandestine ships to Palestine.Many were stopped and the Jews were brought to Cypress where they were interned for 3 years.

In 1947, the British were fed up with ruling the Palestine Mandate and gave the land back to the newly formed UN. The UN decided to split Cisjordan in two giving some land to the Jews and some land to the Arabs. The boundaries of the two newly formed areas was untenable. 85% or the land was Crown Land, 8% was owned by wealthy landlords in Damascus.

The question of the partage was put to a vote in the UN. The Arab countries voted against the decision. The vote went in favour of the Jews. The Arabs in the land began attacking the Jews to drive them out. The Jews had virtually no weapons except what they scrounged from the British. The British left the majority of the weapons with the Arabs. Ben Gurion declared the country as the State of Israel. 5 Arab countries attacks Israel including Iraq, Jordan, Syria, Egypt and Lebanon. No one expected the Jewish state to survive. The war lasted almost 2 years. In the end, Israel gained more territory. 600,000 Arabs left and became refugees in the surrounding countries. Many left because they were afraid of what would happen to them in a Jewish state. The majority left because they were told by the Arab states to leave of their own accord and would be able to return when Israel was defeated. Israel won the war. The Arabs who stayed in Israel prospered and are now 20% of the Israeli population. Those that left were never absorbed into the neighboring Arab countries. They are still called refugees to this day, receiving 2 billion dollars a year from UNRWA.

Meanwhile, 800,000 Jewish were forced to leave Arab countries. Israel took them in as no other country wanted them. They received no compensation for the homes and business that they lost. Many lived in tents for 5 years until the new country was able to build homes for them. Israel doubled its population in 2 years. Israel is the only haven for Jewish people in the world. It must continue to exist. I am a Zionist, meaning that I believe that the Jewish people are a nation and as such have a right to a country. That country is Israel. If you remove the Negev which is desert and is really not livable, Greater Montreal is 10% larger that Israel!!

The Palmach Museum traces the history of the formation of the Palmach and the war which they fought against the 5 Arab countries. The Nakbah at the time referred to the fact that 5 Arab countries with well organized armies were not able to defeat a newly formed nation which had no central army. The was the catastrophe. Later, for the sake of propaganda the Nakbah, or catastrophe became to be used to illustrate the fate of the 600,000 Arabs to become refugees. There were 25 million refugees after WW2. All of these refugees either died, went back to their countries of origin, or were absorbed into the new countries where they were staying. Not so the Palestinian refugees. The Arab countries refused to absorb them and they are still called refugees to this day. The Gazans are the result of this forced migration and call themselves refugees. There are now 6 million Arabs who call themselves Palestinian refugees 80 years after a war. There is no other group in the world which has refugee status for 3 generations. There are 30,000 UNRWA workers in the Middle East with 16,000 in Gaza. Many of these people are Hamas and took part in the Oct. 7 massacre. It is about time that the gravy train stops.

In the afternoon I took a walk through Jaffa. This is the old part of Tel Aviv mostly inhabited by Arabs. Some of the area has been nicely renovated. There are endless streets with shops, restaurants and cafes. I walked along the old port eventually stopping for an ice cream at Golda’s. I am at my usual Thursday evening or Saturday haunt known as the laundromat. What fun.

Love,

Brian

The Palmach Museum

Jaffa

2025-03 Israel

Israel 20,

April 9, 2025,

Hi Everyone,

Good and hopefully wonderful news. The 4 month old baby that we treated 2 days ago has woken up with apparently no neurological deficits. It may however be some time until they see the long term outcome of the event. At the very least, we know that he is on the right track. In my mind, there is no question, the chief paramedic on our team who by his quick action, under difficult circumstances, saved the life of the child. Kol Hakavod. Way to go!

The news from around the world is getting worse and worse. Trumps tariffs, which have not been thought through by anyone who understands world economics, is wreaking havoc on the stock market in the USA, Canada, the EU and Europe. Now, even his billionaire henchmen who surround him, and lavish praise on him are having second thoughts as their portfolios decrease by the billions. No European country will ever trust the USA again. The good will that has taken 80 years to build since WW2, has been destroyed in one fell swoop, by one powerful man. Trump is 99% wrong in all his policies but may be 1% correct in his Middle East policies. He has announced that he will have direct talks with Iran in 3 days on Saturday about Iran’s nuclear policy. Iran has announced that the talks, which will take place in Oman, will be indirect through mediators. Has Trump misspoken and will he back down? I doubt it as it would cause him to lose face which he is not like him even if he is wrong. Here in Israel we are watching, this holding our breaths, with caution and hoping for the best outcome. One way or another, Iran must not acquire nuclear weapons.

Last evening I went to Bat Yam, a suburb of Tel Aviv for dinner with a friend who I met at Sar-el. We had dinner in a beach restaurant overlooking the beach. I ate a fish called mullet which I have only eaten once before here in Tel Aviv. It was delicious.

We had a quiet day with MDA today. The 1st case was a lady who called the ambulance because she had an anxiety attack. The paramedics spoke with her for 1 hour. When it came time for her to come with us in the ambulance to the hospital, she went into her kitchen and brought out a pot of soup that she insisted in bringing with her in the ambulance and to the hospital. This is absolutely not forbidden. A neighbour came over to try to convince her that she could not take the soup with her. In the end, we were forced to leave the lady and her soup behind at curb side.

The 2nd case was an 18 year old girl that had an episode of tonic, clonic epilepsy. This was her first episode and the parents were obviously very frightened. The epileptic fit had finished by the time we got there and had only lasted a few minutes. Her VS were normal as was the EKG. She had not fever. We brought her to the hospital for a full neurological exam, blood work and a CT scan.

The 3rd case was an elderly Russian patient who didn’t feel well. She only spoke a few word of Hebrew. The paramedics did the best they could to get a proper history from her with signs and gestures. They are very patient with patients in these cases. There were changes on her EKG with no discernible chest pain. We took her to Tel Hashomer for further evaluation including blood work, serial EKGs and tropes.

The 4th case concerned a 30 year old female patient who was crying, yelling and had broken a glass in the stairwell. On further questioning which took some time, we were able to conclude that the entire family including the husband, the mother and the father were partners in a totally dysfunctional family. There may have been a court order that a judge had ordered house arrest for the husband and that the wife, who was the patient, had to stay and look after him. Go figure. The police were called for back up but they did not interfere with us. Eventually, after much discussion, the woman came with us to the hospital for stabilization. I was able to talk to the policemen who were motorcycle cops. We got to talking about motorcycles and they were quite impressed that I own a 1973 Triumph 750cc Tiger.

Over the last few days, I have really seen a cross section of Tel Aviv society. If you walk on the beach in Tel Aviv, you falsely may get the impression that everyone is tall, beautiful and in good shape. Once you leave the beach however, you can be surprised with what you see. Some people are overweight. Many of the apartments are somewhat run down. Some apartments are beautiful from the outside and in the lobbies , but the individual apartments are not well kept at all. There is a large immigrant population with different ideas of cleanliness and neatness than our own. Of course, that is what makes a society.

Love,

Brian

Bat Yam Beach

An older and poorer area of Tel Aviv

The fruit and vegetable stores are always good

Motorcycle cops with their permission to publish. Who is the little guy in the middle with white hair?

2025-03 Israel

Israel 19,

April 8, 2025,

Hi Everyone,

It is 36C with cloudy skies, muggy and humid, not at all the weather that I am used to in Tel Aviv. Today was a boring, quiet day with MDA also what I am not used to with the ambulance service. We got our first call at 11:30. We arrived at a nice apartment building in a nice area of Tel Aviv and were shocked by the condition of the apartment that we entered. The couple were hoarders, something that I have only witnessed once in the city. Israelis, even if they are poor, are very clean in their personal apartments. This was an exception. There was rubbage piled up everywhere although the apartment was not particularly dirty. The lady appeared to be about 40, obese weighing 130 kg and lying in bed. Her husband was my size and cleanly dressed. There was a child of about 5 years old, sleeping. Why she was not at school is anybodies guess. We spoke with the woman for a while. She was in no acute distress although she thought that she was in anaphylactic shock from something that she ate yesterday. We convinced her otherwise, reassured her and left her in the care of her husband. What kind of future does the little girl have with parents like this?

The second case was a drug addict that was sleeping in front of a supermarket. She was in no acute distress and not a danger to either herself or the public. She did not want to come with us. The manager wanted us to take her to the hospital by force but we had no authority or reason to do so. We left her and eventually she will find her way home.

The third case was a 63 year old female who had just had an MI, cardiac arrest and resuscitation 3 months ago. She had chest pain that was resolving. Her EKG showed new changes. She refused to come with us to the hospital. 2 of the paramedics spoke with her for 1 hour to try to convince her to come with us. They always have incredible patience with patients. Her Phillipino helper had called the ambulance as she felt that her condition was deteriorating. At one point she asked the paramedic who I was. He introduced me as Dr Brian from Canada. The woman spoke English fluently. I reinforced the point that she had EKG changes and needed to come to Tel Hashomer for further evaluation including an echocardiogram and cardiac trops. She told me that she is afraid of hospitals. I then saw her looking at my chest scar. I told her that I knew from personal experience what chest pain feels like. I explained to her that I am also afraid of hospitals as a patient but sometimes you just have to go. She said that she would like to consult her rabbi, Reb Bal Shem Tov. I told her that it was not necessary as I had already consulted with the Reb and that he had sent me here from Canada to take care of her and have her come with us to the hospital. She laughed and then agreed to come to the hospital in our ambulance. The conversation with me had not taken more that 3 minutes. I later told the paramedics that I thought that had looked at my white hair and decided that I must be right with all my experience in these types of cases. Little did I know…..

Love,

Brian

Modern buildings in Tel Aviv. The architects here are not afraid to be original in their design.

2025-03 Israel

Israel 18,

April 7, 2025,

Hi Everyone,

I wore my Nike running shoes for the first time today and they were wonderful. I was bouncing all over the place each time I took a step, it was a wonder that I didn’t just fly away. I will try running with them in a few days.

I had a new team at MDA today but I was posted on the same base. We checked the ambulance at 6:30 and had our first call at 7:00. We walked up 3 flights of stair and found an 85 year old woman in bed, short of breath. The woman was already on oxygen. The room was 10ft x 10ft. We somehow lifted the patient onto a stretcher. The stretcher is made so that it can turn into a chair which is easier to manage. We then carried her down the stairs to the ambulance and took her to the hospital. She was oedematous and probably in congestive heart failure.

The second case was an elderly man in the very religious sector of Tel Aviv called Bnai Brak. These people have 6-10 children so you see children running around everywhere. It is a shame but religious areas in Israel are often over crowded, run down and dirty. There was garbage everywhere as if people don’t care about cleanliness. The man was short of breath from bradycardia. His pulse was 46 meaning sinus bradycardia, an athlete or a heart block. He was in no acute distress so we took his VS, gave him oxygen and monitored him.

We were on our way to a hospital when we received an emergency call that a child had fallen into the water and was unconscious. When we arrived, the child had already been brought down stairs and 2 paramedics were giving CPR. In a child you give heart massage with your thumbs. They were bagging the child with a mask and oxygen. There was a discussion among the paramedics and it was decided that we had the most experience with children. While continuing with CPR, we transferred our elderly patient to another ambulance and took charge of the child.

The chief paramedic in my ambulance was amazing. He took charge immediately and gave orders to the other paramedics in a calm but direct fashion. We did an EKG and found that the child was flat lined. In this case, defibrilation is not indicated. He got an IV access by directly putting an IV into the knee. He then delivered adrenaline. The ambulance took off at full speed to Schneider Children’s Hospital which is a major children’s hospital in Israel. While the ambulance was moving, he intubated the child which is not an easy manoeuvre to do in a 4 month old child in a moving ambulance. I was very impressed with his work. He obviously has had a lot of experience with infants.

The physicians at the hospital were waiting for us to arrive. By the time we arrived in the hospital we had a pulse with a heart rate and a blood pressure. The chief of the ER took charge immediately. After a few moments, the child started to breath spontaneously but they continued to bag him for support. The child’s pupils were dilated but maybe not fixed which would indicate brain damage.

We left at this point and as usual with MDA, we usually don’t know the final result of our work. The mother looked to be between 25 and 30, ultra religious with a long dress. She had left the child next to the sink for an unknown period of time and for an unknown reason. Somehow the child had rolled over and fallen into the sink, and drowned. We could not find out how long the child was not breathing. The first ambulance was on the scene within minutes and CPR was done immediately. Brain damage begins 4 minutes after a lack of oxygen and is irreversible at 10 minutes. A child can sometimes last longer.

The chief paramedic was sitting alone in the ambulance writing out his report. I went over to him, touched his shoulder and told him that he had done his best. I know that he appreciated my words of support.

The woman sat in the ambulance with us staring ahead with absolutely no emotion. She never spoke or cried. Her husband arrived at the hospital just after us. He was dressed in ultra religious clothes. He also expressed no emotion. The woman will never forgive herself for the 1-2 minutes of inattention. The child is in God’s hands now. Unfortunately, there is no God.

Our last patient was a 6 month old child with a first episode of epilepsy probably viral related. The child had stopped convulsing when we arrived and was waking up. We brought the child to the nearest hospital for further evaluation and treatment.

All in all it was a busy, emotionally packed day.

Love,

Brian

Paramedics

Tel Hashomer Hospital, the 8th best hospital in the world according to Newsweeks evaluation. The country has 9 million people. University of Toronto is 3rd in the world. McGill is in the 90s. It is not surprising if you read my last evaluation of McGill.

Schneider Children’s Hospital

My MDA team

2025-03 2025

Israel 17,

April 6, 2025,

Hi Everyone,

Today was my first day with MDA, Magan David Adom, Israeli civic ambulance service. We do not go to a war zone. Military ambulances take care of war casualties. I was posted at the MDA base in Raman Gan about 30 minutes from Tel Aviv. I was not posted there last year. I was introduced to my 3 paramedics. One was an experienced driver, 1 girl was 19 years old and in training and 1 was 28 years old and has done ambulance service with the army. I was up at 5:30 and had a quick breakfast as the hotel had generous supplied me with a breakfast and lunch to go. With Waze I had no trouble getting to the ambulance base. I have to be at the base at 6:30 to check the medications on the ambulance. They let me check all the medications and although every was written in Hebrew, I was able to make out ok.

Our 1st call was rather simple. A 16 year old girl with tachycardia probably due to stress. We went through the usual routine of a history and physical exam. The patient was not in acute distress. We brought her to the hospital for monitoring and further treatment if necessary.

The 2nd patient was an 84 year old lady with COPD, asthma and diabetes. She was on oxygen chronically. We took a history and physical, started an IV, EKG, blood sugar, temperature, blood pressure, blood oxygen level, pulse, resperation. Her temp was 39 C so she probably had a pneumonia with an exacerbation of asthma and COPD. She was wheezing. We gave her Oxygen, placed her on an ambulance chair and carried her down 3 flights of stairs to our ambulance and brought her to the hospital.

The 3rd patient was a 45 year old patient, overweight who had fallen down the stairs. She was sitting, leaning against the wall in severe pain. She had an open fracture of the lower tibia and fibula, bleeding with her left angulated at 70 degrees.

We started an IV and gave her fentanyl for the pain. She calmed down in a few minutes. We were then able to straighten out the leg and splint the fractured leg to the good leg. We covered the fracture with a bandage. We lifted her onto a sling and then placed her onto a stretcher. Present was a BLS ambulance (basic life support) with 3 paramedics and a ACLS ambulance (advanced cardiac life support) with 3 paramedics and me. It took 6 of us to carry her down 3 flights of a narrow staircase to get her into our ambulance. Then, with sirens blazing, we rushed her to the hospital. The treatment on arrival at the hospital was instantaneous.

I have nothing but good words and praise for the paramedics. They are calm and very kind to the patient and family. They are extremely well trained. They follow protocols which make them efficient and effective. No one ever gets excited. They always know exactly what to do to help the patient. Israel is very well served by the paramedics of MDA.

The 2nd patient was accompanied by her daughter who rode in the ambulance with us. She comes from New Jersey and is in Israel for 3 months to visit with her mother who was the patient. She bought her husband with her to Israel. He was in a wheelchair as he had a traumatic brain injury 12 years ago when, as a pedestrian, was hit by a car. He had 7 brain operations and has obvious deficits. I don’t know how she has the courage to face the day when she wakes up in the morning.

After my cases, I bought a pair of Nike running shoes to replace the shoes that I destroyed on the IDF base. MDA requires closed shoes so my sandals were not acceptable. Great, I needed a new pair of running shoes anyway. My old pair at home are 10 years old. Boy, have running shoes changed in 10 years. These new shoes bounce when I run. Maybe it will help me win more triathlon races. I can’t wait to try them out when I run this week.

Love,

Brian

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