Sunday, September 27, 2009

Erev Yom Kippur Reflections

After a long morning putting in time studying for the boards, I decided to beat most Israelis to the chase...and take a bike ride.

To those of you who have not had the pleasure of spending the Holiest of Days here in the Holy Land, you might need to be informed that while the more religiously inclined of the Israeli population spends their Yom Kippur in the Synagogue, praying and hoping to be "sealed" in the Book of Life, the "Chilonim," or secular Israelis are out riding their bikes.

Why?

Well, because no one drives on Yom Kippur, so the streets are clear for all sorts of recreational activities. "But why does no one drive on Yom Kipper?" is the logical question to ask. Well...I'm not sure. I'd like to say something such as, "The Holiness of the Day is so pervasive that even the Jews who are the most removed from religious practice feel that mundane activities such as driving just don't feel right." Maybe I'd add---riding their bikes, breathing the fresh air, and meditating on the beauty of this country and it's bike-riding people is their way of communing with G!d. Who am I to say that sitting in a cramped synagogue, being hungry, my legs tired from standing-sitting-standing-sitting all day is more of an effective way of achieving forgiveness?

So it was with these thoughts that I took a brief bike ride, though I'm not quite sure it was even remotely similar, because riding on the roads here WITH cars makes mountain climbing feel like a safe, relaxing walk in the park. I was not only thinking about the authentic-Israeli-Yom-Kippur-expereince, but also taking into account this past year and looking ahead to the next one.

I realize (and apologize) that I have been terrible at keeping this blog updated in the past year, but I it was not out of laziness or even being too busy (though it was a factor) that this occurred. Really, my second year of medical school was a year of intense study, which did not permit me much time to experience much outside the confines of the medical school library and the few places I knew I could retreat to for Shabbat---thus, I didn't really have much to share about my "Israel Experience."

In fact, things were becoming so monotonous and not-blog-worthy, that I finally decided that, if I was going to be studying this hard for the rest of medical school, I needed to better surround myself with the things that I considered important---including a functioning Jewish community, friends (outside of school), and access to good schwarma. I found all of these things in Ahuza, the community up in the Haifa mountains, to the South of the Carmel---where my friend Shmuel lives. And, as luck would have it, Shmuel's roommate (Natan) had gotten engaged and was looking for someone to take over the lease when he leaves.

So here I am now, sitting in my new apartment, breathing the thinner, mountain air of Ahuza, and getting ready to go enjoy a pre-Fast meal with one of the many hospitable-to-a-fault families that reside in this neighborhood (ok---there's no such thing as hospitable-to-a-fault...but, if there was, many of these families would qualify).

In the past two weeks, I started my Internal Medicine rotations, which have proven already to be an intense learning experience, where every day is full of the possibilities of both gathering in large amounts of the most important medical knowledge and wisdom to be a better doctor. Every moment presents an opportunity to learn, both technical knowledge from the doctors and nurses who work in our department, and undefinable---yet much more important---wisdom from each patient. I feel that the past two years have been working up to this, and it does not disappoint.

This past summer, I got to spend more time at home than I have since almost the beginning of college. It was wonderful to see everyone I was able to see, spend a few Friday Night dinners with my family, and to get to beat in pool-basketball a few times by various family members. It was exactly what I needed to face the challenging year ahead of me.

This next year will not only be full of externally learning about medicine, but also attempting to learn more about myself and discovering which field is best suited for my unique (....ok, strange...) qualities, strengths, and weaknesses. I also can look forward to taking my USMLE's (Nov. 9th), the visit of one of my brothers (and hopefully the others as well), working on my Hebrew (and possibly Russian and Arabic), and balancing this all with my personal life as well.

As I finish this off to go start getting prepared for Kol Nidre, I wanted to share a beautiful thought on forgiveness that I heard from Rabbi Klapper (with whom I studied the summer before starting medical school). The idea that "forgiveness out of love", which is the highest ideal of forgiveness that we can achieve, can not only completely remove the taint of sin and mitigate the punishment thereof, but actually turn that sin into virtue (as claimed by the Rabbis in the Talmud) is a challenging one for many reasons. One camp---which believes that all of our actions are pre-ordained and only the choice to "fear G!d" or not is decided by our free well---reasons that we can turn our sin into virtue simply be realizing that what we did was not sin at all, but actually part of G!d's larger plan. This is disturbing mostly because it denies any consequences for our actions, among other inherent problems.

Another camp---which believes in the inherent creative ability of Man to recreate himself---argues that when we achieve true forgiveness from G!d, we are like a new person. While this does burden us with more responsibility, it fails to fully explain why those old sins are not just left to be parts of our "old self", but instead become virtues.

The idea that Rabbi Klapper presents is, borrowing from both of these ideas, we can look at the world as a series of opening and closing doors of opportunity to better ourselves, improve the world, and become closer to G!d. Thus, the highest ideal of forgiveness would be the realization that the sins of our past have been done and cannot be changed---they have closed some doors---but, more importantly, they have opened others avenues of redemption. The worst thing we can do is dwell on our past mistakes, and ignore the opportunities that we now have---sometimes precisely because of those mistakes.

I hope everyone has an easy and very meaningful fast, and may you be sealed in the Book of Life for the year to come.

Yours,

Michael

Friday, April 03, 2009

Long Time Coming

After many (well....two) complaints that I should get back on the "blogging" horse, I realized that I miss being able to share some of the craziness of Israel with my wonderful family, friends, and stalkers. But so much has passed since I last blogged that I get very frustrated when I try and think of what to write about. Should I talk about trying to ski up North in the Golan? Any one of the crazy stories involving patients I have had at Afula's HaEmek Hospital? My mildly successful attempts to start a med-school minyan last semester? Hanging out with my Middle School teacher Mr. Uzan and family? Commenting on the war in Gaza? About my friends who fought in the war? About Purim? Or just all the generally crazy things that happen day-in and day-out?

Actually, things aren't that crazy here anymore. My apartment this year is much better behaved, and my neighbors decidedly less crazy (though I did have a humorous episode with the little kids in the apartment across the courtyard from my office window, who started throwing rocks at my window.....and then my roommate pretended to steak up behind me w/ a knife and then fake stab me while the little kids were watching....anyway---they stopped throwing rocks). Classes have---honestly---been taking up much more of my time, and, unfortunately, the library is not that exciting of a place. Neither is my classroom. But, on the bright side, I'm slowly but surely becoming a doctor. Which is the real reason I'm here anyway.

Briefly, to bring everyone up to speed: I started my second semester of my second year about a month ago. I'm taking Specific Pathology, Pharmacology II, Hematology, ICM (Intro to Clinical Medicine), Biostatistics, Epidemiology, and Entrepreneurship in Medicine. That takes up about 90% of my waking life. I also play basketball on Monday nights and sometimes make it to frisbee on Thursdays. I usually spend a few hours a week speaking to various members of my family on the phone, and probably too much time chatting on gchat with friends.

This week, however, I was consumed with one of the most pressing issues I have had to deal with as Chief Representative of the Technion Medical School Class of 2011. No, I'm not referring to a question of ethics, or any sort of medical emergency. I'm talking about vaccinations. That's right. The dean of our program found out that we have not (officially...) been vaccinated, and then all hell broke lose. The hematology professor found out about this, and then informed us that if we were not all vaccinated by the first lab, we would not be allowed into lab, and thus fail the lab, and thus *fail the entire course*. So---our entire medical school class being threatened with repeating a year due to vaccinations, the next day we send a sizable chunk of the class to the Ministry of Health (in the same building as the Ministry of the Interior).

The thing about going to any "Ministry" office in Israel is that there is the following Catch-22: they hate when you show up without an appointment, but they don't answer their phones so that you can MAKE an appointment. To give you an example: when we all need to go to the Ministry of the Interior to renew our Student Visas, they wouldn't even let us into the office TO MAKE AN APPOINTMENT without an appointment (made over the phone). After our brains exploded over this paradox, a quick thinking med student pulled out his cell phone, called the number for the office, and pointed out to the security guard (who wouldn't let us in) that the phone was ringing, and---as usual---no one was picking it up. Finally confronted with this truth, he had no other option but to allow us into the office, where we promptly renewed our visas and went on our way.

So, knowing this to be the case, we were prepared for the worst. So we only sent ten students (note: I was note with them, so this part of the story is pretty much here-say. Do with it what you will). When they got there, the bureaucrat in charge of the office immediately sent seven of them away, saying she could only deal with three people, since she was booked the entire day. The three people who stayed apparently had to argue through the forms, and prove to this lady that they had already received almost all of the necessary vaccinations. Finally, she pointed out they needed to have a TB test---which would take a month. A month? Well, since we are "foreigners", we would actually need two TB tests (assuming the first one was is negative). (By the way, this law, along with lots of other very strange regulations for "foreign doctors" in Israel is due to the fact that most foreign doctors in Israel came from the former USSR---a place which produced a few very good doctors, and a lot of people who got their MD's at a special section in the supermarket...also, TB is somewhat endemic to Russian). Anyway, they were only there for about 30 minutes, at which point they noticed there was no one else there (thus, it was a complete bluff in sending the other students away), and the Ministry would not sign off on their vaccinations until they had proven their lack of TB.

The next day, some students went there just to make appointments, and they were sent away, being told that they shouldn't even come to the Ministry of Health without having first had a TB test. All the while, my entire class was still worried they might be expelled if this weren't done within a month (which was technically impossible due to the TB test's length of time). I finally went to the secretary of our program, told her what had happened at the Ministry of Health, and she promptly called them up and gave them a piece of her mind...Israeli style (i.e LOTS OF YELLING). An hour later, she came to our classroom with a sheet of paper with time slots for everyone in the class to sign up for, which would be reserved for us.

The moral of this story? You can only fight fire with fire. If you have a problem with an Israeli, then you need your own Israeli. I'm thinking of starting a business here for people from America (of which there are many) were you can just call us up, tell us your problem involving other Israelis, and we'll have an Israeli fix the problem for you....for a small fee. Maybe we'll even rent them out for our wealthier customers. Who needs medicine? This will be a big hit.

I better go get ready for Shabbat. I hope to start updating this blog more often now, so....you've got that going for you. I have a lot to say about the new Government here in Israel, but I should probably bite my tongue and at least give them a week or so before I start ranting. Just this for now: this government is like an All-Star team of Israeli Governments. A former Prime Minister....as Prime Minister. A former Prime Minister as Minister of Defense. A former Prime Minister as President. I could go on, but I won't. It's just going to be interesting to see Bibi butt heads with Barak (Obama, not Ehud). We'll see.

Shabbat Shalom everyone!

Michael