Condition Critical by Rothchild Alice

Author:Rothchild, Alice
Language: eng
Format: epub
Publisher: Just World Books
Published: 2016-10-23T16:00:00+00:00

Medicine: If It Doesn’t Kill You, It Makes You Strong

June 25, 2014

The tone of the meeting with the medical students is not that positive. Now I will grant you they had just finished their exams (because of the Hebron curfew and the resultant delays, some had six exams in one day). Many are about to graduate, so they are done with all the frustrations and with living in a variety of ghettos, trying to get an education in an impossible place. One student describes Al Quds as “six years of hell.” The students from East Jerusalem discuss the frustrations of crossing the Qalandia checkpoint twice a day; most everyone has had some frightening experience with a gun-toting Israeli who is also their age and sees every Palestinian as a terrorist. Everyone complains about the uptight culture of the medical field (sounds a lot like the hierarchical culture of US hospitals in the 1970s), physicians who act “like gods,” and of course, the longstanding conflicts with the administration.

As we try to tease apart the miseries of medical school in general from the miseries of this medical school in particular, certain themes emerge. Al Quds (as opposed to An-Najah in Nablus) has no teaching hospital, so students get dispersed all over. Students with IDs or permits for East Jerusalem get better clinical rotations, and there are no standards or clear-cut expectations in the clinical curriculum, so the teaching is enormously variable and sometimes totally inadequate. (Pediatrics at Al Makassed Hospital is a glowing exception.) The doctors are often brilliant, having trained in high-power institutions abroad, but have active private clinics that keep them very busy, and teaching medical students is often low on their list of priorities. In addition, unlike hospitals in the United States, residents (where they exist) are not required to teach the students, so, explain the students, “everything is personal connection.”

The students would love to see the institution improve and are aware that Al Quds has funding issues; the Israeli authorities are not allowing it to build a teaching hospital in Jerusalem. It sounds, nonetheless, like there is an unacceptable level of chaos: students talk about being “dumped” in hospitals in Bethlehem and Hebron, then having to rent crowded apartments in those communities due to the challenges of getting around. They talk about arbitrary grades, a lack of mentors and guidance, and a number of small problems. Everyone plans to train “outside” and everyone “plans to come back.” I love their passion, their rage, and their idealism.

We talk about the challenges for patients. Due to lack of funding, patients having surgery sometimes have to buy their anesthetics, IVs, and pain medicine and bring them to the hospital before the procedure. Some hospitals have no electricity for two hours per day; this would certainly crimp a specialist’s style, not to mention some poor patient on a respirator. If a Ministry of Health hospital is unable to perform some type of care, it will refer the patient to a private hospital,

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