Passover in Israel

Was the Exodus orchestrated by Heaven?

To remember, we avoid any leaven.

Spelt, barley and oats

Wheat and rye’s gluten coats

We don’t eat for days one plus seven.

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 Iowa, Pennsylvania, Nebraska, Canada, and Alaska.  2019 included hospitalist work in my home town and rural medicine in northern British Columbia.   Since the pandemic started, I did 10 months of telemedicine in my basement, staffed a COVID-19 clinic in southeast Iowa, more telemedicine, visited family, attended 4 funerals, worked 12 weeks as a contractor for the Veterans Administration in South Dakota, and traveled to Israel.

I’m Jewish, and I traveled to Israel during Passover.

To find out why I don’t write about politics, religion, or sex, please read https://walkaboutdoc.wordpress.com/2010/09/13/why-i-dont-write-about-religion-politics-or-sex/.

Bethany and I haven’t visited Israel for 2 years, but the Jewish urge to be in the Holy Land during Passover goes back more than 3000 years.  Neither us has celebrated the holiday there until now.  But for all of our lives, every years we say, Next Year in Jerusalem. 

Our daughter lives in Be’er Sheva, not in Jerusalem.  Jerusalem proper goes to chaos for the Jewish holiday and for the Christian Easter that immediately follows. 

(Not all Christians celebrate Easter at the same time, which, sometimes leads to problems.)

We had a lovely seder in Be’er Sheva.  Our daughter honored me by asking me to lead, even though her Hebrew is much better than mine, and Bethany’s Jewish learning exceeded mine until recently. 

I love the Passover story because of its universal relevance.

Sooner or later each person will find themselves re-enacting the Exodus as an individual. Things change: maybe a partner crosses the line from binge drinking to alcoholic, may the good boss gets replaced by the jerk.  The circumstances (geographic, emotional, financial, personal, work, home) become constricted; the Hebrew word for Egypt: Mitzrayim, meaning narrowings.  Successful redemption demands personal action, and frequently requires leadership and help (sometimes, Help).  Redemption never comes easily, and not everyone accepts the opportunity.  The urge to return will tempt the wandering redeemed, who will also face the tension between moral turpitude and moral compass. 

If all works well, we learn, grow, and strengthen.  We come to a set of conclusions having to do with personal integrity.  If we follow those, we come to the land of milk and honey.

On the second day of the 8-day holiday we visited Jerusalem.

Due to travel and internet access, some posts will appear out of order.

Tourists, Maori, and Pakeha; asthma, accidents and impetigo; drama and irony; just another Easter on call

Normal means little goes wrong

My Saturday session went long

     Not much of a purist,

     I took care of the tourists

They came off the road by the throng.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  On sabbatical to avoid burnout, while my non-compete clause ticks away I’m having adventures, visiting family and friends, and working in out-of-the-way places.  On assignment on the North Island of New Zealand, I’m living in an apartment attached to a clinic in Matakana, north of Auckland.

To the delight of my colleagues I work Easters, usually signing up for seventy-two continuous hours.  This year, though, I had to ask four times, and ended up with fifty-four hours.  I kept reassuring the office manager that I was happy to do so.

Wellsford sits on State Highway 1 an hour north of Auckland.  The divided highway gives up halfway to the rough-paved two-lane.  On Friday morning the outbound holiday traffic backed up four kilometers before Wellsford.  I inched along for twenty minutes, arriving on time when I had given myself fifteen extra minutes for delays.

The holiday hypomania permeated the clinic as we prepared for the tsunami of the ill, injured and worried.  Our 8:30 opening patient called from the traffic jam, begging our forgiveness, pledging to arrive as soon as possible but probably fifteen minutes late.

ACC, or Accident Compensation Corporation, accounted for most of the traffic on Friday.  Decades ago the New Zealanders recognized that accidents happen and established a governmental agency to pay for medical treatment for those injuries, in the process doing away with the basis of most tort claims.

Five of Saturday’s thirty-eight patients needed a blue ACC 45 form completed.

Four were Maori, thirty-two were Pakeha or other resident New Zealanders, two came from other countries.  Fourteen were children, twenty-four adults.  I dealt with five by phone or fax and the others face-to-face.

Thirteen had problems involving the skin, including three viral rashes, one case of jaundice with severe itch, two significant traumas, and seven superficial skin infections.

Four had asthma.

Twenty three lived outside the Rodney District; on vacation (which the Kiwis call holiday), most came from Auckland.

One drove an hour to get here.

A fall with a dramatic, bloody consequence led me to a flurry of calls to helpful registrars (the equivalent of US senior residents) until I got the proper surgeon, who instantly agreed to the consultation and gave a couple of helpful hints.

I used the term bicycle, grain sack, grinder, fish hook, and drill when I filled in the Mechanism of Injury section of the ACC 45.  I had to search the computer to figure out how to code lacerations, sprains, fractures, contusions, and puncture wounds.

The real human lessons of trauma have no slot on a form; no government agency collects statistics for patient learned and won’t get injured again, patient still has no insight and will reinjure, adolescent patient acquires life-long damage just because he/she hasn’t figured out how to deal with growing limbs, patient drinks too much, machine injures inventor who intends to redesign, or safety equipment hanging within arm’s reach.

Asthma accounted for another seven patients, worried well for one.

On five occasions I politely but firmly set a limit of one patient per appointment.

With the doors closed and locked, the last patient of the day called; I did not get permission to mention clinical details, nor, given the situation, did I ask.  I can say that every neurotransmitter has a receptor in the intestinal tract.  We all know that high emotions bring abdominal problems, that ambivalence makes our guts roil.  I wanted to say yes to the patient’s request for a home visit, just to view the drama and irony first hand, but travel time to the venue would have put me past my fifteen-minute radius.