February 27, 2006

Alison on Aliyah:  No More Playing Around

            It’s been quite a while since my last article, and quite a lot has happened in the meantime.  My boyfriend has been confronted with some medical problems, and all of a sudden life looks very, very different to me over here.  Over the past month and a half, my Hebrew vocabulary has become enriched with words I never had the opportunity to learn in my basic level ulpan courses, such as “tumor,” “incision,” and “tissue sample.”  I have also been confronted with the vast differences in bedside manner and doctor-patient relationships that exist between America and Israel.  The waiting time is about the same, and one is lucky here if one’s appointment takes place within the hour that it was originally scheduled, as had been my general experience in the U.S.  But once seated in front of the doctor, the similarities in manner between the two countries come to an abrupt halt.

Nurses and secretaries enter and exit the exam room freely, with no regard to the privacy of our conversation or to the possibility that my boyfriend may not be fully clothed at the time of the intrusion.  Both the office phone and the doctor’s personal cell phone ring constantly throughout the meeting, and what is worse, the doctor answers them!  Even in the middle of a sentence of explanation about my boyfriend’s condition and the treatments involved (none of which are at all minor or non-frightening), the doctor would give us a semi-polite nod, consult the phone screen to see whether the caller was more or less important than us, and then pick up the phone and commence a two- to ten-minute conversation as we sat helplessly in front of him.

In the Israeli army, one of the central concepts is “distance,” which is the requirement of an officer to remain removed from the unit of soldiers he leads, so that he can command respect and stay above the personal issues and sentimentalities that could cloud his judgment when dealing with boys that are often older than he is.  What I have found in the Israeli medical system is a surprising lack of this professional distance, which carries with it some serious pros and cons.  On the plus side, my boyfriend has frequently mentioned that he feels very close to some of his doctors, respecting them more because they tend to be (sometimes painfully) frank and honest with him.

On the other hand, part of this candor included one of his doctors unceremoniously giving Mikhael his diagnosis while walking with him through a crowded hallway on the way to his office.  There is no professionalism or regard to personal privacy (at least the type I am used to) here:  life-altering news can be given to a patient over the phone, and private details of a patient’s condition can be discussed freely in a public area of a hospital, frequently with individuals not even related to said patient.  Multiple times I was given Mikhael’s test results, in the name of convenience and less effort output on the side of a given secretary or nurse.  There was no request for my credentials or even proof that I was at all personally connected to Mikhael’s cause.  There was certainly no attention given to the fact that, once faced with important (and complicated) test results in our possession, our uneducated attempts at deciphering them without the assistance of a trained professional inevitably only caused us more panic and fear.  No distance means, really, no distance.

And while I was infuriated by his doctors answering their cell phones during our appointments, an act that struck me as supremely disrespectful of our emotional sensibilities (not to mention our time), the other side of that is that we were also given these personal phone numbers and encouraged to call whenever we felt it necessary.  I have called doctors directly even in the evenings, had them pick up on the first ring, and been treated with patience and kindness.  As of my date of aliyah, I had yet to meet a doctor in the U.S. who didn’t have an unlisted number and who would not have laughed me out of the office at a request for personal contact that couldn’t be billed to the insurance company immediately.

And so it’s hard to know what I prefer.  Part of me wonders whether I would have caught the first flight back to America if I had been faced with a serious medical problem such as this.  My “comfort zone” has been severely challenged throughout this process, and there have been times that I have never felt like such a foreigner, and so isolated from everything I used to take for granted.  Mikhael, on the other hand, has never once wavered.  His parents’ first instinct after hearing the news was to want to bring him back to France, where they would be able to understand the issues in their mother tongue and be in control of what was happening to him.  But Mikhael was adamant:  Israel is now his home and he would approach this problem as an Israeli.  No matter that he didn’t understand a great deal of his doctors’ explanations and no matter that his family is an ocean away.  I suppose a decision like this is what separates the olim chadashim who are truly dedicated from those who are just “playing around” in Israel for a while.  And no matter how frustrated I’ve been with the Israeli system over this past month, it is now quite clear to me that I am not just playing around here.