Many of you know, and many don’t, that sixteen years ago I spent a year and a half volunteering as an ambulance medic for Magen David Adom, the national ambulance service in Israel.  It was a time of terror, fear, and death, but also a time of incredible joy, discovery and growth.  The people I worked with, the patients I met and took care of, prepared me in unexpected ways, for my career as an Emergency Physician.  Here is a piece I wrote back then, about a patient who affected me, tore at my heartstrings, and helped me become who I am today.  Many of my patients teach me not only about medicine, but also about myself and my place in this world.  I hope that this young woman that I met so many years ago can perhaps teach you something as well.

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January 29, 2002

Beit Hanina, Jerusalem, Israel

The second call of our day was one of the most distressing I’ve had to deal with.  My other hard calls – bus bombings, major trauma (car accidents), attempted suicide (two weeks ago, a young mother, OD’d on pills), DOA (man who fell/jumped/was pushed from a roof in Haifa and his brains were on the sidewalk) – were hell as well.  But today’s call was painful for different, deeper, reasons…

We were taken by police escort to Beit Hanina, in East Jerusalem, where we followed a car of men who took us to a residential building.  We climbed the six flights of stairs to find a locked door and a woman screaming behind it.  One of the men (a cousin of the patient) had keys, and unlocked the door.  Inside was a 17 year old girl in her second month of pregnancy.  She was hysterical, crying and screaming.  In the other room lay the heavy black bat that her husband had beaten her with – it was obvious that he had obtained this weapon with the pure intention of hitting his wife with it.  There was no other use for such a bat – it was hewn off at one end and covered in duct tape; the perfect length and size for a strong man to handle as a club.  The young woman was beaten all over her body, from head to feet.  He had punched her repeatedly in the back and in the face, and hit her with the bat in the legs, arms, stomach…even pregnant.  This was not the first time; apparently a similar incident had occurred last year but the police didn’t do anything to the husband.  So the girl stopped calling the police, figuring that her husband’s repeated beatings would just be shrugged off.  This time however, he didn’t only beat her and kick her and step on her – he took her passport and her 1.5 year old daughter’s passport, and dragged the child from the house.  He ran off with her, and the police are out looking for them.  This poor girl, Arab American, far from home and parents, now beaten badly and with her daughter kidnapped by an abusive man.  What a horrific situation.

The girl only spoke Arabic and English, so I became the primary caregiver.  In the apartment I tried my hardest to calm her down, regulate her breathing, and prevent her becoming even more hysterical.  When we finally convinced her to come outside with us, there was a group of men waiting who began to laugh and point at her – these were her husband’s friends.  A bunch of sick, twisted animals, reveling in the pain of a woman.  We took her in the ambulance and while the other medic took her blood pressure and pulse, I held her head in my hands and tried to keep her breathing slowly.  I treated her like I would my sister, stroking her hair and cheek, reassuring her.  She began to calm down, and lay there quietly, crying.

Once at the hospital, we put her in a bed and her aunt was there with her.  I can’t express how incredible a feeling it is to be able to communicate non-verbally with someone – her aunt only spoke Arabic, and she thanked me.  I understood the intention behind her words, and the kiss she blew me from her seat by the bed.  I connected with the look in her eyes, and I felt the emotion behind the hijab she wore.  Those last few moments in the emergency room were intensely beautiful, because I truly felt that connection between people that overrides any cultural, religious, ethnic or political walls that we’ve constructed between us.  Working in Israel in this time of conflict and unrest is amazing because of these moments of connection.  I feel my soul working through my hands when I put those latex gloves on; I can feel my innermost spark reaching towards every person I help.  There is a link forged between souls when my gloved hand touches someone; with healing I reach past concrete and steel walls to touch goodness on the other, hidden, side.

What I felt when I touched that girl today tore me up inside.  I felt the agony of a child stuck in a cage she cannot escape, tormented by the animal of her nightmare world.  I sensed the raging of a captured lioness, unable to free herself or strike back at her oppressor, and incapable of finding her stolen cub.  How helpless she felt, her daughter in the hands of a sadist and her own body hijacked by his fists.  There is only so much I can heal when I come to a scene; I never learned and will never know how to fix wounds of the soul.

My young patient reminded me of my little sisters, and I wanted to take care of her like I take care of them when they cry and need my strength.  I wanted to take her in my arms and rock her like a baby, stroke her hair and tell her ‘everything is going to be all right’.  Unable to reach out to her like that, I settled for stroking her hair and cheek, holding her hand, and making sure she knew I was there and taking care of her.

Why do people do such awful things to each other?  How can a man take a club to his beautiful young wife who is feeding his first child outside and his second child within?  Did the police find him, is the child all right, will he be punished?  Will she go back to him when the bruises fade and her humiliation is but a memory?  Did she lose the baby?

Today was a hard day, but also filled with sunshine.  The rain only started when my shift ended.  The wind woke me up this morning even before my alarm, and stepping outside I was greeted by a sliver of crescent moon and one bright star hanging over Jerusalem.  Perhaps the rain can wash away some of the pain shed on the streets of this city; perhaps the blowing wind can cool down the scrapes on the knees of a hurting nation.  This weekend is the first day of a new month, the new moon.  The month of Adar, the month of joy in our Jewish calendar; the first day of which is my Hebrew birthday.  I will be 24 years old on Sunday.  I will celebrate my birthday.  I will sing with joy at being here, in Jerusalem, in Israel, with my people and our cousins and extended family.  Yes, we try to kill each other, and there is hatred and destruction and murder; but I cannot stop it myself.  I cannot continue to work as a healer and at the same time take in all the pain; I must feel that agony and understand it, but not absorb it.  I must touch it, grasp it, examine it and recognize it; but then I must brush it off my skin like mustard gas.

Instead of putting it in the trash I have immortalized it on these pages.  You know what it is, you know that I have felt it and will feel it again; you are all my witnesses.

If one day I am heartless or cruel, place these words before me and remind me of my own testimony.  In such a way can I help this young patient and the others I will encounter.  My healing skills are not good enough to help them any more than that.