A learning experience

Making a few people obscenely rich is no reason for the USA not to have a health system something like Israel’s. There is no free lunch. But the system works.

Efraim Perlmutter
8 January 2017
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The author,just before surgery.It certainly was a learning experience but let me begin at the beginning.

Our local medical dispensary insists that we take a blood test every year. A week later I had an appointment with Dr Halid (his first name – we go by first names in our neighborhood) to discuss the results. After reviewing them and finding nothing of particular significance, I mentioned to Dr. Halid that I had pulled a muscle in my back, and though it didn’t hurt very much could he prescribe a muscle relaxant which, with rest, was the usual treatment. He agreed but first wanted to check everything in the vicinity of the pain so out came the stethoscope and my life took a very unexpected turn.

After listening very intently Dr. Halid ordered up an urgent electrocardiograph stress test: you are wired up to sensing devices and then run for a few minutes on a treadmill.  Results in hand I was sent off to consult a cardiologist in Ashkelon. Five minutes into the consultation I was scheduled for a cardiac catheterization at Ashkelon’s Barzilai hospital. In this procedure they shove a pipe up your vein from the wrist to your heart.  A device is inserted in order to have a look around and if necessary perform a ballooning process which clears blocked blood vessels or install a stent, a locally invented device to keep the blood vessels open. After it was over, I was wheeled into a recovery room and there met by the specialist who had performed the procedure. With an appreciable sense of humor he asked me if I wanted the good news or bad news first. The good news was that they didn’t install any stents. The bad news was that I needed by-pass surgery. 

Because Barzilai is a government hospital and I belong to the General Sick Fund (the name sounds better in Hebrew) I was transferred by ambulance to the Fund’s Soroka hospital in Beer Sheva. When I suggested that it might be easier and cheaper if I drove there, the nurse in charge seemed scandalized. So with three medics and an ambulance driver in attendance, I was transported to Soroka.

I spent the weekend at the hospital waiting for my scheduled surgery on Sunday. I was the second person to undergo bypass surgery that day. In the meantime my children gathered for the vigil which helped my wife adjust to the situation.  Sunday at about noon I was wheeled into the operating room. I had been given a shot of something to reduce stress and as a consequence I was probably the happiest camper there.

The day before I had a short consultation with the anesthesiologist and I asked if I would have to count backwards from 100. She assured me that this wouldn’t be necessary and indeed it wasn’t. At about one o’clock in the afternoon on Sunday the lights went out. What seemed like only a moment later, I found myself regaining consciousness. The first thing I asked was what day it was and someone told me that it was six o’clock Monday morning. Time flies when one is under sedation.

Later on I was informed that the actual surgery had taken about three hours. Once I had been wheeled into the operating room, my wife and children went to a restaurant at the hospital for food and drink. It’s not often that the kids are all together so they took some pictures of themselves and they all look like they were having a very good time while I was being sliced and diced.

A couple of hours after reviving I was told to leave the bed and sit in a chair. In truth I was in quite a lot of pain, especially when I coughed, which I was encouraged to do in order to keep my lungs clear. I spent Monday night in the intensive care unit and then was transferred back to the Heart and Lung department. It was about then that I noticed that my body was connected to all sorts of things which included a couple of drains for my lungs, a catheter, an electronic heart monitor and some thin wires protruding from my chest which turned out to be electrical outlets for a pacemaker which was used to restart my heart at the end of the surgery and was left in just in case it was needed later. All of these connections became milestones for me in my recovery. As each was disconnected I counted it as progress towards getting home. The drains were removed shortly after leaving the intensive care unit. A day or so later the catheter was removed. On the next to the last day the pacemaker was removed and just as I left the ward, I surrendered the electronic heart monitor. During all of this time various bodily functions were returning to a semblance of normality. I had no appetite for a day or two but I did manage to eat. On the fourth day I had a bowel movement. Normally I don’t discuss such things in public but you have no idea how proud I felt when it happened. For a moment I thought of having the product bronzed and mounted on a wall at home. But then rationality returned and it was flushed away, though I still remember it with fondness.

On Friday I was released from the hospital and sent home with a bag full of medications. That night I had Shabbat (Sabbath) dinner with the family including all of my children and grandchildren. As it happened Friday was also my 74th birthday and I have to admit that it was the best birthday party that I have ever had.


"My wife and (grown) children at the hospital during my surgery, both photos taken on cell phones."openDemocracy is a political discussion site so how could I end this contribution without some discussion of politics. Very shortly after I returned home I became involved in an interchange of emails with some American friends about the election of Trump and what has become known as Obama Care. Here is my response:

When I discuss American politics and get to Obama care I often end up kind of dumbfounded like someone who has just been told that the moon is actually made of green cheese. I get the same feeling when watching Fox news on the same topic. Where do obviously intelligent people get such crazy ideas? And what do you say to them in reply? Well this is my reply now.

I went to my family doctor Halid with what I thought was a pulled muscle in my back, something that I have experienced over the years. Rather than giving me a couple of muscle relaxant tablets and sending me home he listened for himself and decided that he didn’t like what he heard. He sent me off for an electrocardiogram and then to a heart specialist. A procedure and one operation later I have a new set of pipes (no I’m not Scottish) and the prognosis is good for a full recovery. The doctor who first detected the problem as I noted above is named Halid. That is an Arab name and Dr Halid is a Muslim Arab. Along my merry way in this journey I was treated by Jews, Arabs and one guy from some Russian Republic that I have never heard of before. No one asked for a credit card or a cheque but my expenses were shared by a lot of other people just as I am expected to share theirs if need be. There really is no free lunch. But the system works and it seems to me that making a few people obscenely rich is no reason for the USA not to have a health system something like Israel’s.

I would like to conclude with this. Dr Halid, who basically saved my life, and I have never discussed politics. I don’t know if he prefers to be called an Arab, Israeli Arab, Israeli, Palestinian or whatever. My guess is that he prefers doctor. But whatever his preference, that’s up to him. On my last visit I asked him if it was okay to wish him a happy holiday. He replied that during his training and practice he had been to many places and associated with people of many different religions. The one thing he learned was that enjoying everyone’s holidays enriches your life. So we wished each other a happy holiday and I left thinking that not only was Dr. Halid a good doctor but he is also a very wise man.   

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