Israel Road Trip 3: Free advice if you take it.


If you take it, my advice will be free

If not there’s my usual fee

It’s not what you expect

‘Cause I won’t come to collect

And follow up is always the key.

Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, traveled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. I followed 3 years Community Health Center work with further travel and adventures in temporary positions in Arctic Alaska, rural Iowa, suburban Pennsylvania, western Nebraska, Canada, and South Central Alaska.  I split the summer between hospitalist work in my home town and rural medicine in northern British Columbia.  After less time off than I planned, I did some more hospital work and am now vacationing in Israel.   Any identifiable patient information, including that of my wife, has been used with permission.

Bethany and I traveled into Tel Aviv by train one morning to visit our neighbor’s cousin, who spent years in the States and during that time visited frequently.  We had lunch with her, her parents, and children.

I recounted the story of my uncle Pinchas, from his conscription into the Kaisar’s army through his Russian POW experience and release, the odyssey of his return to Galicia, the move to Palestine, the loss of my aunts and cousins to the Nazis, his fight in Israel’s War of Independence, and the reunion with my grandmother in 1965, after a separation of more than 50 years.

As I age I find myself choked up more and more when I tell that story, but tell it I did, stopping frequently to dry my eyes and unchoke.

We all told stories of our families, and I learned that Israel has a national holiday, Yom Olim that celebrates the immigrants. Part of the tradition includes school children telling the story of how their family came to Israel.

While Jews have always lived both outside and inside the Holy Land, Israel takes much national pride in its status as a nation of immigrants.

At the end, our neighbor’s cousin’s mother asked my professional opinion.  The pain in her feet, she said, had baffled half a dozen doctors and wasn’t getting better.  I said, “Tell me about your problem,” then I said, “Tell me more,” then I said, “What else?”  After that I went into directed questions.  I explained that I don’t have an Israeli license, and at the end I gave my opinion, strongly advised some lab tests, and a clinical algorithm.  I explained I suffer from the same problem that I think she has, and emphasized the necessity of pursuing the diagnosis and not just trying a supplement for a suspected deficiency.  She accessed her lab work on her smart phone and scratched several items off my list but found a vitamin deficiency surprising for an Israeli but almost universal in North America, that had not been addressed.

I wanted to show off my clinical technique.  I can’t always help the patient but I can always listen.

At the end, I said, “My advice is free if you take it.  It you don’t, I expect a payment of $50.”

I’m Jewish and I’m visiting Israel.  I’ve written before about why I don’t write about politics, religion, or sex: https://walkaboutdoc.wordpress.com/2010/09/13/why-i-dont-write-about-religion-politics-or-sex/

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