A Day in the Life, by second year medical student Sara Teichholtz

About a year ago, I was reading this very blog and trying to image what life would be like at MSIH. I was (and still am, technically) in my second year of medical school already, but knew I had to submit an application to transfer after finding out about the program here. A year later, I'm excited to be here at MSIH and to be a part of the first year blog! My first year at MSIH is a little different from most since I went straight into second year after completing first-year orientation, but this means I can fill in while the first years finish their exams.

Last year while applying I loved reading the first year blog to hear directly from the students at MSIH. I especially appreciated the posts that talked about daily life in medical school and around Beer-Sheva. So, I present to you now a photo series of what goes on behind the scenes in the class of 2016.5.

For the first month of school, the first years were in ulpan and emergency medicine courses. Here, my ulpan class makes a helicopter landing (a very common occurrence, as we have learned) into a teaching moment, learning the words for “Up,” “Down,” and, finally, how to communicate a helicopter's arrival using only gestures.

We quickly became friends in Emergency Medicine, where we learned CPR and other life-saving maneuvers.

We met the second years at the annual AMSA sale where we were able to buy housewares from upperclassmen. The second years did an amazing job organizing the sale, making sure that customers were never without water or cake.

After orientation, the first years began their coursework in the basic sciences while the second years warmly welcomed me into their class. Second year starts off with some anatomy before jumping back into organ systems, so we spent a lot of time in the lab and in our lab coats. (More if we happened to get stuck inside the lab. But that's another story). Another perk of being around second years is picking up the wisdom that comes with having one year of medical school under your belt, like using said lab coats to smuggle snacks into the library.

However, separate curriculums don't really keep the two classes apart. Outside the classroom, we can be found spending time together.

For instance, during an impromptu game of sports-ball at the hospital in between lectures:

Or putting on our MSIH idol fundraiser event:

So while we each class is having its own adventures, at the end of the day it doesn't matter whether you're class of 2016, 2017, or 2016.5. We're all MSIH. - Sara Teichholtz, blogger of the month

My unexpected oasis, by Britany Weissman, November blogger of the month

View from the sixth floor of Soroka Medical Center.

Four months after arriving in Beer Sheva, I have begun to appreciate a patch of greenery in the desert. This green oasis exists within the borders of the Soroka Medical Center campus.  Soroka is unlike any hospital I am familiar with back home in New York City. Other, more familiar hospitals are comprised of one or two vertical buildings with different wings and extensions added over the years.

In contrast, Soroka is a sprawling, beautiful campus, similar to a compact college.  There are various small buildings, each with a different purpose, providing different services. The courtyard connecting these buildings is covered with trees and green grass.  Real flourishing grass. Not the astroturf which “grows” in front of my new apartment building in the Dalet neighborhood.

Our days in medical school are long, occasionally ending as late as 5:00pm or 7:00pm.  It is refreshing to step out onto the beautiful green lawns of the hospital campus to absorb the sun’s rays, and appreciate the scenery.  The lawns of Soroka reveal a microcosm of the diversity that makes Beer Sheva and the Negev region of Israel so unique.  At any given moment, one can see patients and loved ones, doctors, nurses, students, Jews, Bedouins, and one or two Beer Sheva cats, all enjoying the fertile relief of this lush spot in the desert.  Patients on stretchers are being transported, hospital employees drive carts of freshly laundered sheets, and students bike from one building to another.

Sometimes, the floor to ceiling windows in our classroom are open, allowing warm breezes and streaming sunlight from this beautiful green patch in the desert to infiltrate our room.  There is a communal sigh of disappointment when the professor closes the window and curtains to make it easier to view PowerPoint slides.

The weather in Beer Sheva has been beautiful these past few weeks.  The temperature has fallen from the painfully hot days of July and August to comfortable temperatures in the mid 20s°C or high 70s°F for Americans.  I know that cold weather awaits me when I travel home this winter, and I will have to reacquaint myself with down coats, boots, and gloves.  Even in Beer Sheva there has been a change.  I felt raindrops falling on me in the desert for the first time.  For now, however, I will continue to enjoy the warm Beer Sheva sun from the green grass of the Soroka Medical Center.  - Britany Weissman, blogger of the month

Thoughts on Stories, by Esther Lee

Thoughts on stories (photo by Joy Moy)

I’ve been thinking about the purpose of writing. I’ve joined a creative writing circle on BGU camps and we are meeting early this week to talk about the pieces we’ve worked on. I haven’t started yet, and I’m not sure how far I’ll get with it today. It’s been a quiet, odd weekend. The clouds were heavy in the mornings and there’s talk of rain. It’s an odd feeling when the atmosphere has yet to decide if it’s going to pour, or dry the ground underneath it.

I think the reason we write is manifold. For me, sometimes I write because I process best through writing. Most often I like to write by hand: 0.4mm black ink on firm Moleskine paper (I admit I’m a snob when it comes to paper). Sometimes I write because I have to, like these blog posts and the poem I need to start; sometimes it just comes and I write in the moment.

We have been communicating by the written form for a long time. But before words and symbols, we depended on oral traditions and story-telling. Sadly most of our oral traditions have petered out. How many of us grew up listening to stories from our grandparents/parents/relatives/that crazy uncle? How many of us remember those stories? Will we pass on our stories to the next generation? Most of us have even outgrown handwritten letters and have stopped passing notes in class (now we do the silent messaging thing on our smartphones).

All of us have stories. We carry them with us wherever we go. Sometimes they are heavy, a foggy mess of emotions vs. logic that refuse to untangle with time. Some of our stories are wondrously knitted together and testify to the power of grace. The stories we carry with us build over time. They are important to share with others. And as students of medicine and as global health advocates, I think it’s important that we care about the stories our patients bring when they come in with their chief complaint.

Most of us will have to talk to our patients regardless of our preference, our shyness, the patients’ desires etc. The charts will give us hard data, but patients aren’t a neat conglomeration of numbers and percentages. We are in medicine not purely because of the logic to it; we are in medicine because we truly care about people. Caring for people means understanding. And understanding comes from communication, and communication comes from listening to their stories. Ultimately, how we interpret data is based on how well we know the patient.

I was talking the other night with some of my peers on the topic of reading fiction (“stories”). It’s hard to set boundaries for yourself, so that every waking moment of your day you aren’t a slave to Firecracker (a question bank of sorts for med school).But I believe it’s important to make those boundaries for yourself. To do things that relate to people, whether that’s volunteering here in Israel, reading stories, taking the time to really enjoy a conversation… Part of the reason why I’m trying hard to read and write in med school is to remind myself of the power of stories and communicating them. When my patient approaches me, I want to be curious about their story. How did they get here? What’s the real reason behind the physical symptom that brought them here? What are they really afraid of? How does their culture or religion affect how they think about the illness? These are the questions we need to keep with us as we begin our lifelong commitment to global medicine, even now as students. Patients are not puzzles to be solved, or problems to be fixed. We must not forget our patients are real, walking and talking stories, just like us.  

- Esther Lee, October blogger of the month

"For us, there is only the trying" by Esther Lee

              

So here I am, in the middle way, having had twenty years—

Twenty years largely wasted, the years of l'entre deux guerres

Trying to learn to use words, and every attempt 

Is a wholly new start, and a different kind of failure

One of my favorite collections is “Four Quartets”, by T. S. Eliot. It’s a set of four poems, titled after rock formation a manor house (“Burnt Norton”), a place of his ancestors (“East Coker”), rock formations (“The Dry Salvages”), and an anglican community (“Little Gidding”). There is something powerful about titles that speak about places, geographical or of the social construct. Titles like that are an invitation to readers to go see those places for themselves. They do not explain, as much as they present.

Like Eliot wrote in “East Coker”, I’m still trying to learn to use words. It’s been over twenty years, and I’m still trying. Some attempts have hurt others; some of smoothed over old scars; some have been my hands and my voice across the seas. These days I’m been trying to choose words that I hope can capture some of my experiences here in Israel. There is something powerful about titles that liken to physical places, yes, but perhaps there is more strength to titles that are mental constructs. For me, the mental house I’ve been working on - testing out some of the new scaffolding, trying out a promising shade of paint in the past few months I’ve been living here - is about the idea of home (no surprise). I’m not caught in between two wars. I’m between two (or more) homes, cultures, languages, two lives.

               Because one has only learnt to get the better of words

               For the thing one no longer has to say, or the way in which

               One is no longer disposed to say it. And so each venture

               Is a new beginning, a raid on the inarticulate

               With shabby equipment always deteriorating

               In the general mess of imprecision of feeling,

               Undisciplined squads of emotion. 

In this new house construction project, I’m trying to use words to fill the empty rooms and the bare walls. I’m trying to get the better of the familiar words I’ve used before. I borrow words from others; I reflect on my classmates’ experiences and our conversations in the break room and walking to and from class; I wonder at the upperclassmen’s smooth sailing and confidence in their completed “houses”. How did they conquer the “imprecision of feeling, / Undisciplined squads of emotion” that accompanies new building projects? So often I grimace at my lack of desire to settle, let alone build and put some roots down. My head tells me I’m here for four years, it’s the rational thing to make it my home as soon as possible; my heart tells me I’m missing some crucial pieces, like family; and my spirit just squats in the dirt and refuses to try anymore. My equipment is shabby, it’s old and falling to pieces. Perhaps it’s overused.

Maybe I’m thinking too linearly. It’s not about gaining or losing. It’s not about making the perfect house because all other constructions are unfit for living in. It’s not an either/or choice. Not that all constructs are good for us, or honestly reflect where we are in life. A lot of the times we fill our house with fluff, daydreams and apathy (or just dust, as is the reality in Beersheva). Some meaning is changed and some meaning is replaced depending on where we physically are, and that is ok. Perhaps the most important part to this process is the attempts. The social attempts we make at making friends with the grocery cashiers and the neighbors; all the attempts at Hebrew in public; and all the attempts at ignoring the differences between here and the other home, or homes.

               And what there is to conquer

               By strength and submission, has already been discovered

               Once or twice, or several times, by men whom one cannot hope

               To emulate—but there is no competition—

               There is only the fight to recover what has been lost

               And found and lost again and again: and now, under conditions

               That seem unpropitious. But perhaps neither gain nor loss.

               For us, there is only the trying. The rest is not our business.

                                                                                                             - blogger of the month, Esther Lee

I left this home of the last four years, tucked away in western NY, for the desert (photo Andrea Pacheco

A big part of home construction is food: cooking, inviting, and eating.

And of course, trying out some new foods particular to this land.

Another part of home is physical place. I had to explore strange and crowded places (though when I go back to the shuk in Jerusalem I know where to get my fresh baked goodies)

Walking the off-beaten paths helped, too. This is a beautifully, compact country that needs to be explored.

You need trust to make a home.

And importantly, friends you trust to make a home with.

How Literature brought me to Beer-Sheva, by blogger of the month, Esther Lee

a little bit of green in the Negev desert right on campus. Perfect for naps, making some vitamin D, and hanging out with the classmates

About ten months ago I was in an Immigrant Literature class where I first read about Israel and the Middle East. Even though I travelled a lot as a child and grew up in five-ish countries, I hadn’t experienced anything middle east before coming here. My freshmen year I studied in London for a semester and backpacked around afterwards and the closest to the middle east I got was (this is going to sound terrible) eating my first falafel in London. The Middle East was an enigma to me, till now. All I had were exaggerated news updates, videos of protests and riots, religious tensions and a big muddle of politics I had little desire to probe.

So it was natural that I was introduced to the Middle East not through a history or language class, but through my odd literature interests. I discovered Amos Oz in Immigrant Lit and it was through his autobiography, A Tale of Love and Darkness, that I experienced rich complexity of ideology, cultures, and religion that has shaped Israel. I had no clue that I would be living in Israel that same year, writing a blog post for medical school, sitting amongst a splendidly arranged display of his works in various translations, in the library archives.

It all came about while wandering on campus to find a good study spot, when I happened to pass by his displays again, this time I tried to strike up a conversation with the lady at the desk - “Does Amos Oz still lecture here?” We ended up talking for a bit and he gifted me one of his books, The Same Sea, the topic of Oz’s next lecture series after we firmly established the fact that we both enjoy his works. I’m hoping to attend some of his lectures next semester – an ultimate challenge to work on my Hebrew!

Little encounters and unexpected dialogs like this make a place like… (dare I say it), like something one can call a home. It’s the silent mutual agreement with your housemates, or realizing that the cashier at the Aroma café is familiar with how you like your coffee now (black and strong, please), or commiserating with classmates about school (we just had our second final exam, in biostatistics). It’s the familiar smell of the falafel (must resist) on the corner street near my apartment. It’s running into Anette* again on my way home and realizing again that global health is not as simple as we sometimes talk about. The more we’re committed to setting our roots down wherever we are, the more likely we’ll notice that home can be created where we are in that moment. We can work in global health anywhere – including somewhere you consider home - when we’ve garnered the strength to settle anywhere on this shared globe.

Apart from these musings and extraordinary conversations, school is still school. How to describe it? The amount of information is perhaps ridiculously, just too much. It’s like trying to take a dainty sip of water out of a bursting fire hydrant while everyone is watching you. Somehow, we shoulder on. Each one of us is still figuring out how to function like a normal being in med school, here in Israel.

Dan, Hannah, Jody, Jody, and Xiaochuan representing “B7”/Beersheva before the Oath Ceremony!

Last week was also a week of “firsts”. Last weekend we had our Physicians Oath Ceremony, where we commemorated the start of our lifelong pursuit of learning medicine and dedicating ourselves to the service of others. 

Joy counting colonies from a urine streak on nutrient agar plates. I think we concluded that the “patient” had some sort of infection

We had our first microbiology labs and worked with Staphylococcus, Bacillus, Streptococcus, E. coliand other fun creatures. We learned how to operate the “vending machines” in the hospital that give you neatly packaged white coats according to size (!!). And I discovered a new coffee shop on campus with cheap challah sandwiches.

Classmates looking snazzy after stopping by the white coat vending machine. Ready for microbiology lab! (Photo: Eric Tsu)

I won’t pretend that it’s easy being here. But I’m learning to take joy in the little things, like unexpected chats about authors. These are the small fragments, I think, that are required in making a home.  - blogger of the month, Esther Lee

Neighborhood Global Health, by Esther Lee, blogger of the month

Right before our Succoth break we had “Intro to Anthro to Global Health and Medicine”, an introductory course for the global health modules we will be taking the rest of our time here. For three days we listened, learned, debated, talked over each other, asked pointed questions, and got the importance of timeliness drilled into us (one of our first encounters with Dr. Seema Biswas was her not-so-subtly reprimanding us for not being on time, which means being early, to lecture).

I think, for most of us, we felt. We felt the pangs of our current situation: listening to lectures about healthcare inequalities, economic power plays in developing countries, political tensions that get in the way of appropriate healthcare – all while sitting in a nice, air-conditioned auditorium at Ben Gurion. I felt drawn to jump into the action now, even though I felt like I little to offer as a student.

When will we be able to treat patients, regardless of race, ethnicity, religious affiliation, citizenship, or cultural barriers? When will we be able to apply our global health head knowledge to real situations, not just with role-playing classmates and hypothetical scenarios?

I walked home after the last Global Health lecture with my earphones jammed in, feeling the hot afternoon sun on the back of my neck. I was really looking forward to the ten days off for Succoth.

“Excuse me, do you have Acamol?” a petite lady wearing a baggy sweater with dusty leather sandals, waved her hand in my face to get my attention.

To tell you the truth, I was going to ignore her. I had almost a million errands to run before getting on a train to start my “Sea to Sea hike” (must do before graduating! High chance of photos in next blog). I was mentally exhausted from the last three days of Global Health. And, it was really, really hot.

I tugged my earphones out.

“What’s Acamol?”  She gave me a look of disbelief -  rightly so, as it’s one of the most common medicines in Israel [Israeli brand of Paracetamol, I had to look it up to write this] - then patiently explained, by pointing to her temple, that she has a headache and that Acamol makes it go away.

I have to admit something else -  I had Tylenol with me that I could give to her and go on my way, but after three days of Global Health I couldn’t do it with a clean conscience.

I asked her why she doesn’t have it with her, after all, it’s a common painkiller and we live in a city - there’s sure to be a pharmacy in our neighborhood. But what about the socioeconomic factors unique to her life? Can she afford the medication? Is the pharmacy close to her home? Is she physically capable of walking there alone even if she could afford it? Does someone have to take her? Or is it something in her diet and lifestyle that is triggering her headaches? (Global Health has influenced even my small-talk skills).

I discovered that she has the money, but not a lot; she doesn’t know where the nearest pharmacy is; she would be grateful if I went to the pharmacy and got them for her (I asked); her stash of Acamol that her doctor prescribed is all gone and that she can’t go to her doctor again alone because of her some hidden complexity in her insurance plan.

We talked for over half an hour in the Beersheva heat on the side of the street. I watched her face lit up as she talked about her childhood in Poland and immigrating to Israel. She mentioned the difficulty of moving to the Negev as a young wife with four babies. And how she misses her old home she lived with her husband, the one with the spacious front patio, the one that her children made her sell to come live with them in dusty and crowded city.

She wasn’t asking me for medicine. She was asking me for things that money can’t buy. Time, sincerity, someone who could look her in the eyes and listen to her.  She also wasn’t just an old lady on the verge of losing her mind, looking for someone to listen to her ramble.

When I asked her if she drank enough water, or if she drank tea or coffee (triggers of headaches), she gave me a wide mischievous smile and told me she couldn’t live without her morning cup of joy. We high-fived in whole-hearted agreement (but I didn’t forget to remind her to drink water afterwards).

And, when I asked her if she cooks and what she eats at home, she gave me a look as if she knew what I was getting at – I was hoping to subtly check for a hint of elderly abuse since she is a widower

with one of her children - and answered that she loves Italian food and that an organization brings homemade cooking to her house sometimes. Her sweet, smug grin lingered in the air between us.

We didn’t talk about Acamol again, or the headache. (She reminded me how much she misses her patio throughout the whole conversation). We finally exchanged names. She asked about me, and when I told her I was studying medicine she told me that it is a worthy pursuit. She told me the next time she sees me, she’ll greet me properly with, “Hi Doc!”

“Don’t give up, never” she told me as we parted ways. She’s right. This road that we’ve chosen is lengthy, tedious, and is terrible for our social lives. Sometimes we doubt our decision to come study medicine in a foreign country. I know I’ve had my bouts of gripping fear and uncertainty in being here. But we’re here for a reason, and I believe that the more committed we are to being fully here and the more willing we are to set our roots down in this desert, we’ll see the little reasons of why we came to Israel.

I think the encounter with Anette* was a small answer to why I came here.  I’m here not only to study medicine through a global perspective, but also to practice loving the people, culture, and context, wherever I happen to me. I’m realizing that sometimes we put down roots through unexpected ways.

Now that we’re here, we are doing all it takes to keep going, to keep pushing our lonely roots down in the dry, cracked soil. We must remember that we’re here for a reason.  So whether studying bacteriology, lysosomal storage diseases, or drawing out biochemical pathways for the tenth time, or filling out medical school essays, interviewing, and playing the waiting game - Don’t give up, never. We’re in this journey for a reason greater than we are.   - Esther Lee, blogger of the month

*Pseudonym

Some pictures of the sea to sea hike! Started on the Mediterranean, from the coastal city of Nahariya.

We spent the first day walking through a nature reserve park. The stream crossings kept us from getting too hot.

Walking through valleys and looking up at mountains makes one feel appropriately small and humble.

Sleeping on the shore of the Yam Kineret (Sea of Galilee) after 4 days and ~ 60km and waking up to a striking sunrise was an appropriate way to end our hike.

Our Global Health Shuk....by blogger Jonah Kreniske

It is almost cliché to note how easy it can in medical school be to become so focused on detail that you lose sight of the broader picture. As day follows day of lecture, and night follows night of clicking through Powerpoint slides and memorizing biochemical pathways, it is no challenge to forget why you learn what you learn. In fact, it is sometimes said you can get everything you need to know in the first two years of medical school from Wikipedia. As far as the USMLE is concerned, that may be true. Wherever you are in the world, whatever the quality of your education, there is a compendium of basic facts in a clearly delineated range of subjects that you must know by the end of your second year. These are the things you need to know in order to be granted your MD. I wonder though, is this all that we ought to know?

            For the past week, British trained Trauma surgeon Dr. Seema Biswas has guided my class through very full days of lectures and discussion on global health. Regaling us with tales from her time training the surgeons of Somaliland and her Red Cross relief missions, as well as from her current work at Ziv Hospital in Tzfat, Along with Dr. Biswas, we had the privilege of hearing from Dr. Wajdi Safadi, another Ziv trauma surgeon who has founded a clinic in his Golan Heights town of Majdal Shams.          

Dr. Safadi explained to us how he works 7 days a week, split between his clinic and his hospital position, in order to bring healthcare to his community, where there had been none. Dr. Biswas described working in South Africa, and her recent training in Germany for an upcoming mission with the Red Cross. The orientation culminated with a ‘Global Health Shuk,’ where we were invited to get started on our own work, by engaging with local leaders in community health and humanitarian projects.

The orientation is over now and we are on vacation. But our education continues. The slow rocking of an early morning train is carrying four of us up the coast, bleary eyed, as the sun rises overhead. Five days after beginning our course on global health, we have caught the 3am train to Akko, heading to Dr. Safadi’s clinic on Israel’s northern border. People sometimes ask why we would come all the way to Be’er Sheva, for medical school. The answer is because we are chasing after what we ought to know.  - Jonah Kreniske, blogger of the month

What matters most, by Jonah Kreniske

A gentle breeze wafts in from the balcony, sliding through my open door and bringing a welcome chill. I step out and rest my hands on the iron banister. In the distance I can make out the hills of Ramot, barely lit by a low, rust colored moon.  My neighborhood, Gimmel, winds out below me. Undulating Hebrew and Arabic beats from nearby apartment complexes mix with the usual classic rock standards from Coca bar up the street.  If it were daytime, you would hear the Ethiopian children across the street playing in the yard of the New Immigrant Absorption Center. But it is almost one in the morning, and they are sleeping now. I should probably be sleeping too. Instead, I’m standing here, breathing in the city. From my balcony I can see Soroka Hospital. A shining invitation to the unwell of the desert night, it is a slice of sleek modernity in the dusty streets.

The past month, in that hospital, has been a whirlwind introduction to our new lives as physicians in training. We have met our classmates and together we have absorbed myriad lectures, and trudged through hours of intensive Ulpan. Now, in this rare moment of relative calm, I look across at the maternity clinic, and I wonder if someone is being born behind those walls. It’s comforting to remember that life begins here. On Monday, walking past the ER to my first class, a weeping woman swept past me. Glancing towards the ER doors she had burst out of, I saw another woman writhing on the floor. An ambulance had just arrived. Never have I heard so much pain in the voice of another human being as I heard in the cries of that woman outside the ER, on my way to 8am class.  At Soroka we see what we might push to the back of our minds in another context. We see illness and death, birth and health, side-by side, tipping weights on a human scale.  

“Good medicine is not about killing microbes, it is about keeping human bodies in balance,” one professor reminded us. On the hospital campus, in the tireless work of the physicians and nurses who pace its halls, and in the aspiring faces of my classmates, I see the will to maintain that balance. In the struggle to provide care, I see the physical manifestation of the compassionate instinct that I would like to believe is somewhere in all of us. As I step back into my room for the night, I know another long day of classes awaits us in the mounting heat of the morning, but I also know that this day will be another small drop on the side of the scale that matters most. - Jonah Kreniske, September blogger of the month

The Puzzled Self, by Elon Richman

I saw a movie recently called The Night Train To Lisbon. In it there was a powerful line:

"When we visit a place or we're with someone, we leave a piece of ourselves that can always be returned to and rediscovered."

Keeping that in mind.

Jonah and I walk home from an enticing and satisfying dinner at Big Kahuna Burger and look up at the Soroka skyline beside us.



“And there’s Soroka looking as beautiful as ever,” he says.

I laugh and turn to him “Beautiful? I mean the lights make it look impressive but I don’t think beautiful is the right descriptor.”

He replies, “I think it’s beautiful that human beings would invest that [gestures toward the hospital] much energy, time and resources into the health and well being of each other.”

I hope I never forget that.

I hope I never forget that there is an everlasting balance between the soul and brain of medicine. That at times we view the body as a machine and at times as a person. At times it is a vessel of knowledge, and at times it is a knowledgeable vessel.

But it is always both.

And I hope I remember that I’m leaving pieces of myself wherever I go. They’re reminders of who I once was as well as gifts for those who will carry me with them.

We’ve spoken recently of class trust and bonding, the idea that within all of us lies the capability to receive a piece of another and hold it forever. It’s up to the individual to decide how much responsibility to accept. We’ve even acted on that trust with poking and maneuvering of sharp needles in the dermis of our neighbors.

           

         

                                     

Yet receiving another is just a step closer to self-realization. What is the process by which we accept others? How do we reflect another’s piece back to them? How do we see ourselves in another?

Through self-reflection and self-observation we can begin the undertaking of amending the mental framework by which we give and receive. Not that any person is faulted in their judgment, but acceptance is a lifelong journey that those of us studying global health have the privilege to explore more deeply. It’s the vast diversity of human existence that makes us hungry.

And acceptance IS important; it’s impossible to know one’s self without knowing and exploring others. The doctor is a teacher, and by this very notion should understand more than any not just the fundamental machinery of the body, but the additional enigma that is the human experience.

Time is infinite, but it allows for specificity, and now is as good a time as any for us to begin realizing what it means to give, accept and trust.

I continue walking home after marinating on Jonah’s insight and stand before the expansive skies of Abraham’s Negev. It’s dark, and a feeling of semi-fiction makes me question the brilliant stars, “What will I remember? What will I forget? How can I be the man, the doctor, that needs to assist in repairing the world?”

Funny, they say there’s no sea in Be’er Sheva, yet the winds echo the crashing of ocean waves. And with them comes an answer:

Try your best.

-Elon Richman, August blogger of the month

A Day Twice Reflected, by blogger of the month Elon Richman

Today was long.

I woke up at 7:30 am to attend three and a half hours of intensive Hebrew language where our teacher drills us and drills us with verb conjugations and nouns. Its a steady barrage of “what the are you saying” and “will I ever really be able to have a conversation with someone in this bizarre language without sounding like a child.”

After a short lunch, I am warmly greeted by five hours of “this is how you treat the absolute worst case scenario that ever could possibly happen to a human being” and a repetitive series of mouth to mouth resuscitation with age old alcohol wiped plastic dolls.

When I think about the work that awaits me over the next four years of medical school, I begin to tremble.

I’m walking home from yet another ten-hour day and look up at a fiery bright orange sky remembering that momma said there’d be days like this. Days of stress and uncertainty. Days when I didn’t wake up on the right side of the bed or I’m just having trouble seeing the big picture.

So I think I’ll try today again.

I wake up to a cool morning. The light is shining gently on yet another peaceful Be’er Sheva dawn as the city churns and people leave for work. I sip green tea, eat fresh bread and look off my balcony at the doors of Soroka who readily await my arrival.

On my way in, I take a detour towards Coffee Time where the barista knows me and doesn’t need to ask my order. We smile and greet each other with a cheerful boker tov and I’m off with my warm coffee. That first cup of muddy black Turkish brew hits my lips and blesses me with the gift of God’s strength and energy.

I’m ready.

It’s now Ulpan time and Nava, our charismatic and oddly humorous teacher, gives us the tools to describe our world around us (both in the streets and behind hospital doors).  I notice my language progress from the last few weeks and smile at the entirely wide and new array of people I can communicate with because of this tongue.

During lunch I talk with my classmates and we laugh over food and more coffee. Conversations vary and I’m thankful to rest my mind for an hour and change before going to the next series of lessons. As we walk to Emergency Medicine at around 1 o’clock, it’s hot, but my body thanks me for the warmth after being inside for so long.

We arrive. It’s time to start pumping adrenaline as information is hurdled at us and we’re encouraged to think on our toes.

“Head trauma? Infant Foreign Body Obstructions? Safety first!”

I arm myself with knowledge. What pleasure it is to feel readiness and confidence as I imagine jumping at the chance of aiding those in distress. Bring it on.

6:00 rolls around and I’m off school. I swing by the pool and lunge head first into the engulfing waters. The intensity of my workouts keeps me alive, pulling at the water and pushing the limits of my body slightly further every time. I sense the resistance against me as I glide through. Even better is the clear mind and feeling of euphoria after a full hour of intense swimming. It’s like meditation, concentrating so fiercely on my activity until the release, when tension is put to rest.

I’m walking home now against a fantastically beautiful Be’er Sheva sunset. I smell the plants. I touch things. I feel my feet steadily kiss the sidewalk as I walk home with a clear mind.

I reflect on my accomplishments from today and excite my nerves with tomorrow’s prospects. What new Hebrew words will I learn? What new restaurant should I try?

I think about this weekend. What will I do? Who will I see? What new place can I discover?

There are so many ways we can view our day to day lives in medical school. It can be a stressful rush of chores and appointments, or a beautiful array of sensation and life. It’s easy to lose sight of why we’re here.

My advice? Smell more plants, touch more things, talk to more people. When you find your balance starting to sway in the wrong direction, take notice and readjust. Bring everything back to the present time.

Don’t dissolve the day’s powder in a glass and drink. Instead, let her breathe. Smell the essence, taste the bitter and sweet, and live forever in the infinitesimal granules of every moment.

The late Israeli comedian Talia Shapira once said wisely:

.התחילה כבר החיים ,לב שמת לא אם

If you haven’t noticed, life has already begun.  -Elon Richman, August blogger of the month

Homebody, by blogger of the month Elon Richman

So its like this.

People have noticed that I regularly draw a house on my ankle. It’s simple: a square frame, triangular roof, a doorway and a rectangular chimney with smoke from the top (its lived in).

I don’t draw on myself because I’m bored in class. Its a meaningful reaffirmation and a statement of my self respect and self love.

Wait, what?

While working at a coffee house in Tel Aviv I decided to come up with ideas for tattoos. Something basic, not too crazy, and preferably a picture that I could design and even tattoo onto myself with household materials (that last part was / still is very questionable).

So I drew. First it was Mr. Peanut, then a bear with a cigarette in its mouth (morning shifts are long) and finally a house.

Why did I draw this simple house?

At first the house reminded me of my home in Miami, a beautiful 1920’s, Mediterranean style abode where I spent my childhood and fondest memories. It made me homesick. 

But then I remembered that I came to Israel to see if I could actually feel at home in what I’ve always considered my second country.

Finally I asked myself: What is home?

Is it where you grew up? Where you’ve lived most of your life? Where people know you? Is it where your friends are? Your family? Is it the place where your dogs are? 

What does it feel like to be at home?

I concluded that the home is not necessarily a specific place. It is where one feels complete and whole, a place from where warmth and comfort generate. 

Where do those feelings come from?

When faced with these kinds of existential questions I tend to turn toward my learnings in meditation and Buddhist philosophy. From that perspective, it seems to me that warmth and completeness arise from within.

Warmth and completeness from within.

That means it doesn’t really matter in what specific location you put yourself. Home is a mindset and can be created in any Bedouin capital in which you may happen to be. All you need are the right tools to build it. Personally, I build with friends, love, routine, a good mind and a sweet patio. 

But everyone has different specifications.

Now, I’m not saying I’ve never felt “homesick”, but feelings are transient. Missing a place means its special, but it doesn’t mean that you must be there or that it is the only place you belong. If one can feel truly present, other homes will have less of a grasp (by present I mean feeling in touch with both the outer and inner environments. Its hard).

We’re all building houses in Israel. So as you continue to form the structure of your life here, think about the roof that’ll protect you from hard times, think about the walls that will keep in the warmth and think about the windows of perspective from which you would like to look. 

And make sure your door is open for guests.

So now, every time I sit down and put my feet up, I see the house and remember that my body is my home and the vessel by which I experience it. I redraw it every day and reaffirm this message to myself: 

Home is wherever I am. 

Home is wherever you are.  - blogger of the month, Elon Richman

And so it was chosen, by blogger of the month Elon Richman

That 38 medical students from around the world would come to the cradle of civilization (ish) to study the world’s most amazing field. Flavors from South Korea, Philippines, Canada, USA, Taiwan, and lets not forget Nigeria, just made the diverse melting pot of Israel that much spicier. The group is mixing, juices are flowing and we’ve so much left to know of each other.

My Israeli experience is quite different from that of my peers. I’ve grown up coming here, am familiar with the culture and have been to the ends of the country on multiple occasions. But, like most tourists who come to visit Israel, Be’er Sheva was easily skipped.

After spending the last two months working in a coffee house in Tel Aviv, Be’er Sheva actually became a welcome change from the hectic honks and hoots of a cosmopolitan metropolis (much to the surprise of my friends who asked “Why the hell are you leaving the beach?!) Yet, I moved because I sought experience; I sought change. So far, Be’er Sheva has delivered with its shuks, charming old city and incredibly diverse immigrant population.

Even better, though, is the student experience.

This isn’t your average medical school. I chose MSIH because it offers a gateway to meeting fascinating and curious people who are interested in more than your run of the mill medical school experience. We have a kung fu master, paratrooper (who’s afraid of heights), salsa dancers, foodies, hikers, swimmers, bikers, spiritual guides, travelers... You get the idea.

This diversity of interest, however, doesn’t strike me as the most amazing quality of our class: everyone here is unique, but in the most welcoming and accepting way possible. There’s no intimidation from the incredible tales of our classmates and since the start of our orientation sessions, our class of 38 has been in each other’s company. We’ve had fun in the sun, dined in ancient streets, danced, explored and engaged in learning ancient language. And if you’re looking for challenges, we have people ready to face them with you.

Luckily, there are simple answers to all of your Be’er Sheva problems!

Are the chickens waking you up at 6:00 am?

YOU CHOSE THIS

Did the falafel stand on Bialik give you diarrhea last night?

YOU CHOSE THIS

Coca Again?!

YOU CHOSE THIS

I couldn't possibly go on another apartment tour.

YOU CHOSE THIS

להזיז מהדרך האמריקנים משוגעים!

YOU CHOSE THIS

Who’s the real sociopath! (ahem)

YOU CHOSE THIS

...but wait.

Have you met interesting people from around the world?

YOU CHOSE THIS

Have you started feeling that Israeli spirit?

YOU CHOSE THIS

Are you as excited as everyone else for these next four years?

YOU CHOSE THIS

We journeyed from around the world, but we’re here now. The path ahead is laid with bricks of uncertainty, but I look forward to continuing this great energy as we start a thrilling and dramatic year of knowledge, culture and love of life.

So let me ask you one thing: How can I global help you?

Naaaaaiiiiimmmm Meeeeeoooooddd,

- blogger of the month Elon Richman