Friday, May 11, 2012

When it Hits the Fan in Israel, Healthwise

Shalom, chaverim! I'd planned to tell you all about a lovely "tiyuul" (excursion) Elul and I took to Acco earlier this week, but that will have to wait. Instead, I wanted to share my most recent experience with another branch of the Israeli healthcare system--that of being in the hospital in Nahariya.

Wednesday morning started like any other school day, but at 9:20 a.m., I was struck by excruciating pain in my lower abdomen, on the right side. "What the heck?!" I thought. About two weeks ago, I'd had an ultrasound that had picked up "something" on my right ovary. Cyst? Fibroid? Cancerous tumor? The doctors had decided to watch it for awhile instead of doing a biopsy, which was fine with me. But now at Ulpan, I was in pain and bleeding. Holy smokes, had the "something" burst?

I decided to go to the Maccabi clinic, which was conveniently located right next door to our Ulpan. My own doctor wasn't based at that particular clinic, but I knew that if I were to get a referral to the Emergency Room at the hospital, any doctor would be able to do it. It took some time, but eventually I did see one. After giving him my medical history (this was to be the first time that day), he immediately wrote the referral letter and told us to take a cab to the E.R.

The clinic staff kindly called us a cab, but while we were waiting outside--Elul pacing nervously and me doubled over in pain and clinging onto a handrail to keep from falling--an Israeli woman who was passing by stopped and asked if we needed any help. Elul told her we were waiting for a cab to get to the Emergency Room, and without batting an eye, she said "I'll take you. My car is right around the corner. Wait here and I'll come get you."

Of all things, our guardian angel had been an English teacher her whole career. Her name was Nomi, and while we were driving to the hospital we exchanged phone numbers. She even called me twice during my stay in the hospital. What a mensch!

You're in the system now! My hospital I.D. tag.

I'd been referred to the women's section of the E.R., and after some waiting time I saw the doctor. I gave him my medical history and told him about the tumor on my ovary as being possibly part of the problem. He immediately did a vaginal ultrasound on me and said "Tumor? What tumor? Who told you that you had a tumor? When did they tell you that? You don't have any tumor. Whatever problem you're having, it isn't anything to do with gynaecology, so go next door to the trauma section of the E.R. Zeho!" ("That's it!")

So I did, and that's where they starting thinking I might have appendicitis instead. Time started taking on that hazy, gauzy quality, which is what happens when you find yourself having fallen right through the looking-glass, like Alice. However, the staff were just so terrific and kind. One attendant, Daniel, looked after me (and the other ten or so other patients) during most of my hours there. He had a brother in Hollywood who lived very close to my own brother in Hollywood, and was familiar with their neighborhood. I still haven't stopped being surprised by the number of extraordinary connections Israelis have with America.

Eventually, I saw a resident doctor and then the attending surgeon, and gave each of them my medical history once again. Since the first doctor had dismissed any "female problems" as being the cause, and the pain was still mainly on the right side of my abdomen, the diagnosis shifted to being a possible case of appendicitis. I was hooked up to an I.V. and began fasting. They had me do a full ultrasound first, but didn't find anything wrong with my appendix. Then they did a C.T. scan (after drinking ten cups of dye--yick--and waiting for hours for it to "move through,"), and didn't find anything, either. Baffling!

Although it was subsiding, the pain was still there, so they decided to keep me overnight. Around midnight, I got into a room with two other women. With a new nurse and another new doctor I blearily went through my whole medical history for the fourth time that day. Everyone who's ever been in a hospital knows that hospitals have their own culture, and systems that are firmly in place and are hard to change. This one was no exception, in that even though it was the middle of the night and the two other women in my room were trying to sleep, when I came in, all the lights came on in the room and the interviews and temperature and blood-pressure checks began, complete with rattling carts and beeping machines. My poor roommates--I still feel bad for having caused them to awaken in the middle of the night.

Since I'd come straight from Ulpan, I had nothing with me at all. I'd given Elul all my jewelry and my wallet, since I knew things have a way of getting "lost" in hospitals very quickly, and I didn't want the mental hassle of needing to guard my belongings. I'd kept Elul's cellphone and a notebook and a pen, and that was it. Just keeping track of those three little things was difficult enough. I was given a pair of hospital pajamas and another couple of bags of I.V. solution, and then at last it was lights out.

That morning, though, I woke with a rotten headache that felt like a migraine.  I asked for some aspirin, but it took awhile as the beleaguered nurses needed to attend to more urgent needs, which I understood completely. But I was tired, and dirty, and upset, and scared, and hungry, and I just lost it. I started bawling like a baby and couldn't manage to control myself. In fact, the harder I tried to stop crying, the harder I cried. A nurse came running in, apologized profusely for not getting me aspirin sooner (!), and gave me some nasty-tasting liquid that she put under my tongue. I don't know what it was, exactly, but it sure did the trick. I was just bowled over by the fact that she was apologizing to me. I apologized to her for bothering her! There were people in that ward who were a lot worse off than me and had far more pain than just a headache, and I knew it.

The doctors and nurses in Israel are amazing. They get paid very little, have to maintain very high standards, and to top it off, most of them speak at least three, if not five, languages. My roommates spoke Arabic and Russian as their first languages, respectively. All of the doctors and nurses I came in contact with moved seamlessly between English and Hebrew with me, Arabic and Hebrew with my first roommate, and Russian and Hebrew with my other roommate. How many hours did all these people spend learning not only their medical professions, but also manage to become polyglots as well?

Later, a new doctor came in and I gave him my history for the fifth time. The pain was much less, and he determined that I wouldn't need surgery for appendicitis. I wondered aloud if the pain had been caused by the ovarian tumor having burst, which is why the first doctor couldn't see it anymore on his scan. However, this new doctor replied that he HAD seen the tumor on the CT scan.

I was confused. "But, the first doctor said I didn't have any tumor! In fact, he challenged me when I told him about it." And the new doctor, to my astonishment, said  "Oh, that guy's just a resident. I saw the C.T. scan myself, and it's still there. So I'm going to send you back to the same department, but with a more senior doctor who knows what he's doing." Zonk!

The good news was, the doctor also said I didn't need to be on an I.V. anymore and that I could eat and drink again. I'd been fasting for close to 18 hours, so that was wonderful to hear. I asked for some food and got some plain yogurt. But just as I was about to dig in, an orderly appeared to wheel me off to my next destination. No matter, I wolfed it down while being wheeled at high speed through the hospital, with the added bonus of receiving a lecture from another orderly in the elevator who insisted I should be adding sugar to my yogurt to make it taste better. I told him I was just grateful I had any yogurt at all.

So, like Bill Murray in an Israeli medical version of "Groundhog Day,"  we went back to the department where I'd started the journey, and saw the more senior doctor. Doing another scan, he not only saw the tumor, but he also saw some other little fibroids and clumps of stuff (this "stuff" had a name, but I didn't understand it) on my ovaries and uterus, and said that's why I was having pain and crazy bouts of bleeding. He said there was nothing to worry about, and that he'd prescribe me some hormone replacement therapy medicine. I finished with him at about 10:00 a.m, and he said that he'd write a letter giving permission for me to be released. "Bingo!" I thought. "I'll be out of here by lunchtime."

It only took them until 6 p.m. that evening to get their paperwork together enough to release me. Oy!

Elul arrived just as the final set of doctors came to spring me. He came with a change of clothes for me, a toothbrush and toothpaste, and a thermos full of homemade coffee. We got in a taxi and I arrived home to a clean apartment, a beautiful welcome-home bouquet of flowers, a hot shower, and two kittens who appeared to have grown by 50% in two days. Heaven!
The Israeli medical system really did take incredible care of me. Had I been in America when this happened, even with the crappy insurance I had there, the 20% co-pay added to the $5,000 deductible would have bankrupted us. Since I followed the proper procedure by going to a clinic first and getting a referral to the E.R., my total charge for all that care will be a grand total of zero shekels. I knew moving to Israel was a good move in practical terms--I'm just surprised I was proved right so quickly. We've only been here four months!
Shabbat shalom, everyone!


  1. OMG, Selah! What a story! I hope you are feeling better and the therapy will work well for you. BTW, I have really been enjoying your blog, even though we never really new each other in Delray, it's been fun to watch you adjust and grow. You are a fantastic writer so it makes the reading fun. Thank you for your gift and for sharing it with the world!
    -Rivka Felsher

  2. Thank you so much for your kind wishes and ego-satisfying praise, Rivka! :) I feel just great now, particularly now that the cancer scare I've been going through these past weeks is now officially over. Whoo hoo!

  3. Hi. Glad to hear you have 'survived.' One of the benefits of Israeli medicine is the right for a second opinion, which I suggest.

  4. Hey Selah, I'm so glad you are all right and that I was able to spend a lovely Shabbat service with you once again. I love hearing you sing and so enjoy your blog. Thanks for sharing all your details during your stay in the hospital and I hope I don't have to use it in the near future...but, I did learn from your experience things to do to that can make it easier.




Thank you for reading my blog. I am interested in your comments, but I will delete anything that is either spam or just plain nasty. Please do not use the comments forum as a political or religious soapbox--there are SO many other online forums for those kinds of tedious arguments!