Wednesday, July 18, 2012

Being Human in Inhumane Times

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Being Human in Inhumane Times

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.... I will apply, for the benefit of the sick, all measures which are required... Words from the modern version of the Hippocratic Oath, written in 1964 by Louis Lasagna, academic Dean of the School of medicine at Tufts University, and used in many healing schools today.

In the West Bank city of Nablus, an 18-year-old boy is busy making ready nail bombs. The explosive materials are temperamental - taken from old ammunition. One wrong move and these hastily made bombs can explode. This boy, like many 18-year-olds the world over, is learning a trade. The dissimilarity is that in his case, the fruits of his labor will be packed into knapsacks and sent straight through a series of illegal channels into Israel to be exploded in crowded areas for maximum impact. Incremental death is his part of career success.

But life is ironic and things do not all the time go according to plan. The boy adds too much sulfuric acid to the ammunition's existing potassium chloride and in the blink of an eye, there's an explosion. Many people hear the deafening sounds and come running. When they arrive in the shambles that was mere minutes ago a local bomb-making facility, they find the boy lying on the floor. His hands -- the tools of his trade -- are mangled.

The irony doesn't end there. The boy ends up on a stretcher at Israel's elite Tel Hashomer Hospital, escorted by Israeli soldiers, being ready for microsurgery. His future bodily and economic well-being are now in the hands of a top-notch Jewish Israeli healing team. Five Israeli surgeons, micro surgeons and hand specialists, using the most industrialized technology available, will work for hours to save those hands.

How ironic is this peculiar inversion of the sentiments described in the Hippocratic Oath? First, do no harm..... To those who would harm you.

But according to the doctors, it's all in a days work: staying humane in the face of inhumanity.

For those who are not part of the healing profession, this is a difficult scenario to accept. Think how you would feel being an active participant in salvage the life of man who was hell-bent on ending yours. How does one behave reasonably in unreasonable circumstances?

For the mean person, it is incomprehensible. But the trauma doctors working in Israeli hospitals are not mean people. For them the essence of the Hippocratic Oath is sacred: Treat the sick to the best of one's ability... Without regard for race, religion, political affiliation or borders.

"Once man is in your care, you are their doctor and it is your responsibility to do your job," explains plastic surgeon David Mendes, a member of the Tel HaShomer crisis team, practically matter-of-factly. David was born in Israel but raised in America and educated at Cornell healing School. He recently returned to Israel after 32 years. "When man is brought into our operating theatre we don't stop to discuss his politics."

Mendes says that many of the Palestinian people that the team operates on are children and their healing issues are not connected to the Intifada. "Many of our (Palestinian) patients are born with deformities or other healing problems. They are unable to get the care they need in the areas where they live." straight through a program sponsored by the Peres center for Peace, founded in 1996 by old Prime priest Shimon Peres, they have access to Israeli healing facilities.

Their families go to great lengths to arrange the paperwork they want to come into Israel and see Israeli doctors. Mendes describes the popular ,favorite paperwork to enter Israel as a glimmer of hope for these people.

Mendes speedily adds that the families of his Palestinian patients are deeply appreciative. They arrive at the Israeli entry checkpoints with the absolute bare necessities. Anyone extra in their possession pretty much guarantees that they will be delayed in reaching their hospital destination.

"They arrive at the hospital with the clothes on their backs and the patient. That's pretty much it. We help them with food and lodgings because they cannot afford to go back and forth every day. I don't mean monetarily. I mean that every time a suicide bomber succeeds at entering Israel and setting off a bomb, border security tightens exponentially. And if a Palestinian house goes home for the evening, there is no warrant that they will be able to gain entry the next day.

"Before I went to healing school, I worked as a paramedic in New York City. Every day we were out there rescuing people who were murderers, thieves and drug addicts. Regardless of what caused them to arrive at their present situation, we picked them up, put them on stretchers and got them to a hospital as speedily as we could. Because at the end of the day human life is sacred."

According to the World health assosication (Who), practically 4500 Palestinian patients are admitted to Israeli hospitals every year and practically 9000 Palestinians are referred to Israel annually for ambulatory and laboratory tests. The Who also notes that the numbers of Palestinians entering Israel for healing reasons has decreased significantly since September 2000, as a follow of Palestinian policy. And the Pa has rejected all Israeli offers of health assistance.

If one believes daily international media reports, it is impossible to believe that there are acts of kindness and human decency that happen here every day - yet there are. Some are big and some are small, but all are unnoticed and unreported to the world, a world that is quick to criticize what it does not understand. It is much more comfortable to fancy that the more industrialized side is taking benefit of the less industrialized side.

Josef Haik, director of the burns unit at Tel HaShomer, described the ethical behavior of the Israeli healing society as "humbling". "Believe it or not," says Dr. Haik, "medical care in Israel is truly color blind to politics."

And that's why some doctors now believe that they have to speak up and tell Israel's story.

On any given day, surgeons, pediatricians, and other healing professionals see practically as many children from Gaza and the West Bank as they do from Israel. The Peres center for Peace established its program to identify, diagnose and treat Palestinian children in Israeli hospitals and recovery centers because favorable medicine is not ready in the Palestinian Authority-controlled areas despite the fact that billions of dollars and euros are channeled to the Pa specifically for that purpose every year.

In other cases, Israeli and Palestinian doctors work in partnership to refer and take in patients. Dealing with cleft palates, deformed skulls, burns and wounds are all part of a day's work for pediatric plastic surgeons here.

And because these are involved procedures that want much planning and follow-up, there is an unexpected side-effect: friendship and respect. When a case requires on-going care, doctors and patients inevitably build relationships. The bridges that are built here have succeeded in ways that no political negotiations have to date.

And it all goes on unnoticed by the face world. The doctors don't do it for applause. The patients don't publicly praise the doctors for fear of repercussions. And the world passes judgment without having all the facts.

"It is so shocking for me," says Mendes, apparently reasoning out loud. "The international media report practically every day how horrible Israel is to the Palestinians. I guess the media aren't interested in the truth. But the truth is that there are many Israelis out there who are actively helping Palestinians - not because they are Palestinians, and not because they support their politics, but because they are people. Period. And some of these people have healing problems that we can remedy."

One could say that healing care should be blind to all things beyond the healing problem, but for these doctors, hospitals are often extensions of battlefields and bomb manufacture facilities. And one can only wonder if the young bomb maker whose hands were saved has been changed by his Israeli healing sense or either he will plainly take his carefully repaired hands and go back to work.

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