Happy families

Many people have commented that the blog has gradually taken on a negative tone over the recent months. It’s not the most surprising turn of events – life is difficult for both of us, while I’m in the army. While I’m on base, Deborah is home alone while I work endlessly with dozens of repetitive medical cases. Long hours, irritating lack of facilities and resources, ungrateful patients. When I come home, we endeavour to make the most of our time together, but that time is very short, and once I recover from the fatigue of a long period on base, it’s time to start getting stressed about the imminent return.

I’m writing this on a plane from Manchester to Tel Aviv. When the opportunity arose to take a week off while my soldiers were in the process of transferring between bases, I decided that I would seize the chance to see my family. No friends, no locum work to raise cash, just some quality family time, to break up the would-have-been 13 months between parental visits. Deborah has started work in Shaarei Tzedek Hospital now, which is great news in every way, except for the fact that it means she hasn’t been with me on this trip.

We’re coming up to the two year mark since we made aliyah; a good time to stop, take note of where we’re heading, and so assess if we are who we want to be, doing what we want. On paper, we’ve achieved all our dreams, including those we could only have hoped for: we both have the jobs we dreamed of, own a home in Jerusalem, have made great friends, speak the language, and can be proud of the fact that we took the plunge, came to Israel, and as the cliché goes, are helping to build Am Yisrael.

But something is missing.

With the exception of those people most inspired and motivated by faith in G-d, as time goes by, ideology fades. It’s difficult, for example, to ration my showers to a couple of minutes to save every drop of precious water in our arid land, when some Israeli-born soldiers are quite happy to wander off to answer a phone call, without turning off their shower first. It’s difficult to work 100 hours per week for a salary less than half that I would receive in the UK, when so many Israelis ask me for advice on how to get work permits abroad. And I’ll never come to terms with watching ultra-orthodox men drop litter on the streets of Jerusalem, the holiest place in the world for them, when I wouldn’t dream of dropping a piece of paper even in the slums of Manchester.

I can’t tell you what is missing from life – but something is affecting our fulfilment. Is it lack of purpose? I don’t think so – even here we can both confidently declare that our jobs give something to the country and the wider population. Is it financial security? No – we’d definitely be better off in the UK, but we aren’t struggling either. Is it gratitude? Perhaps in small part - now especially, during my army time, I dearly miss the simple ‘please’ and ‘thank-you’ of a happy patient.

One thing that is clearly missing – family.

We were under no illusions when we made aliyah. We knew we were leaving family behind; but for a greater good and a bigger picture – to create our own family here in Israel, so that future generations could grow up at home, with their families close by. Our own deprivation would be a small price to pay so that one day our children might grow up close by – even if our kids might not get to spend every weekend with their grandparents, at least we could spend time with our grandchildren one day! Plenty of other people have gone through the same thing... but sometimes the timing is better; they may move when the kids are already a little bit older. Perhaps they have family in Israel, or parents who can visit every month or two.

Whatever the reason, suddenly the distance between our parents and us has been profound. From babysitting to teenager advice, from moral support during labour to help deciding which school to send them off to, we have lost a very useful commodity! All that said, despite the tone of this email, Deborah is NOT up the duff; the plan still remains that we wait until my release from the army, and have a once-in-a-lifetime year trip before we start settling down and trying for sprogs. However, as our friends start to be fruitful and multiply, at home and in the UK, we’ve found yet another reason to appreciate good, loving and supportive parents. Despite the difficulties and frustrations of living in such a special place (no, not Liverpool), at the very least it gives us an appreciation of family that so many people just take for granted.

There are many questions and choices ahead. A lot to decide, and a lot at stake; do we stay in Israel, or come back to the UK? If we come back to the UK, how long for? But whatever our outcomes and wherever we end up, we will have tried our best.

It could be me....

You may recall that I earlier mentioned my reasons for choosing to come to the base I did, based primarily on the frequency of the visits home. There are several bases like mine based around the country, each one for a different Battalion, each one a training base for the new soldiers to arrive.

My second choice was a base down in the south of the country, between the city of Be’er Sheva and the city of Eilat, deep in the desert. The perk of my base is that it’s fairly close to Jerusalem, and a three hour bus journey gets me home, whereas the other base is at least 6 hours’ bus travel. On the other hand, the other base has a swimming pool, and a daily flight to Tel Aviv, meaning that the journey home would only be about three hours... as long as I managed to get a place on the flight (and overlooking my environmental principles).

In the end, I left it to fate, and ended up here. A good friend of mine went to the other base – a new immigrant from Russia, just engaged and due to marry in a few months, and a thoroughly nice bloke.

Two weeks after I arrived on the base, occurred the terrorist attacks in the south of the country that resulted in the current tensions with Egypt; in short, a group of terrorists from Gaza entered Egypt, travelled south, and infiltrated Israel close to Eilat. Armed with Kalashnikovs, grenades, surface-to-air missiles, and various explosives, they started to attack traffic on the roads – targeting two civilian buses taking people north from the Red Sea. In the resulting gunfight when Israeli troops arrived at the scene, several Egyptian policemen who had also responded to the attack were killed. Though it is still not clear whether they were killed by the terrorists or by friendly fire from Israel, their deaths have resulted in a massive uproar among the Egyptian population. Even though the Egyptian government does not view the deaths as an act of aggression, the population has rioted, attacked the Israeli embassy, and held regular demonstrations calling for Israel’s destruction. Nice.

I learned on my gap year here many moons ago that it was no surprise to find friends involved in terrorist attacks. I lost a British friend to a suicide bomber in 2002, and myself have had some very blessed moments – for example, when I caught my bus with less than a minute to spare, only to hear that the next one had been blown up, killing twenty people. When I found that a friend had just missed the first bus targeted in the Eilat attack, I was of course relieved, but it was not a life-changing moment.

This week, I found out that the attack happened in the catchment area of my second-choice base. The result: at the precise moment of the attack, while I was sitting in a conference about follow-up of radiology in the army with a load of the region’s bureaucrats, my friend was scrambled to the scene in his ambulance.

As the first medics, they quickly entered the scene and began to treat the multiple wounded, identifying those with no possibility of survival and treating the rest, as per the protocols drilled into us during our training.

Within a short time, the gunfire started. The terrorists had set an ambush, killing innocents and then waiting for the army to arrive. Powerless, weaponless, and outnumbered by the terrorists, the medical team ran for cover and hid behind rocks, waiting for infantry to arrive. As their armoured ambulance was sprayed with bullets, and civilians lay bleeding on the floor, there was literally nothing to do.

In time, backup arrived, the threats were neutralised (not before they tried to shoot down a helicopter ambulance with a missile), and none of the medical team were badly injured (although an infantry soldier of 20 years old lost his life).

My friend’s experiences hammered home two things to me; ironically, I’m the one in the dangerous base. We have both armoured and unarmoured ambulances, we never leave the base without at least one weapon, and my roads are amongst the most treacherous in the region from a traffic point of view. It was just the decision of G-d that I’m here and not there. Despite the mundane intensity of much of my clinic work, it taught me to remember that there could be a time when I’m in that position.

Several months ago, an old friend of mine came to visit from the UK – a Christian girl I knew in University, who came on a ‘study trip’ to learn about the Israel-Palestinian conflict, and the area as a whole. We only had time to meet for a short period, but it was a very difficult meeting; I had come from my base, in uniform, complete with my weapon; and immediately that she saw it, the look of dismay was evident. As we talked through the group’s itinerary, it became horrifyingly obvious that the group was receiving a warped view of the entire situation. From the trip to graffiti on the ‘apartheid wall’, to the art displays of the ‘victims of occupation’, to the very fact that their guide the entire time was a Palestinian, their choice of accommodation primarily in Arab areas, and the lack of time spent in any main-stream Israeli society, it became so clear to me how easily people can be shown a story from one view point and develop a sincere impression that they understand ‘the bigger picture’.

After a walk around, I took her back to her group, who were touring the Old City. As we approached, most of the group simply turned their backs and refused to look at or talk to this mercenary of the illegal Zionist occupation of Palestine. Two or three graciously managed to smile and say hello, and one even shook my hand. As my friend pointed out, it takes a great deal of courage for a pacifist to shake the hand of a soldier holding a semi-automatic  machine gun. She also pointed out, ‘if you just put down your weapons, there wouldn’t need to be any fighting’. Apparently.

When I arrived to my position on my base, I made the decision not to take a weapon. I decided that, as a doctor, who declared both at graduation, and at my swearing-in ceremony to the army, that I will treat all humans equally, friend or foe, carrying a weapon would be a paradox.

As the United Nations stands to hear a Palestinian declaration of independence, my base has ascended to full alert, in anticipation of the potential chaos that may ensue. As my colleague more than 50 miles from any disputed territory drives around in an ambulance with matching holes on each side where bullets passed through, I’ve made my decision. Next week, I shall sign on for a weapon, at least until things settle down, and I will feel no shame. If our enemies cannot respect the sanctity of life, they could at least respect the rules of international warfare and the Geneva Convention, that state that medical personnel and vehicles cannot be targeted. While Hamas used ambulances to carry weapons for exactly that reason in the Gaza war of 2006, I will continue to honour my pledge to protect human life.

Including my own.

A few highlights of the first months as an army doctor

Arriving to base for the first time

As my bus wound through desolate barren hills, past the occasional goat, rock rabbit, and dried-out skeleton of a bush, in the distance, I could see a large, developed army base – complete with an area for tanks, a formal reception and inspection area, and a nice stone wall with a sign reading ‘Welcome to the Regional HQ of 900 Battalion’. My bus pulled up, and as I descended, I confirmed with the driver that this was indeed my base. “No! You’re the next stop”.
So, we departed, and turned off the narrow winding road on to a narrow winding single-track. Some 5 minutes later, we arrived at a very much less impressive base. So as to prevent provocation of the extremists who try to kill us, most army bases in the West Bank, including mine, are intended to be temporary structures – every building is brought on the back of a lorry, and so the base is in effect a collection of static caravans, with pipes often running over the ground, electric cables overhead, poor drainage, and worse food (though still significantly better than on my previous base). The base is fairly cramped, and extremely hot. Nestled between hills on every side, there is virtually no wind, and in a desert below sea-level that means the night time temperature rarely drops below 30 degrees in the summer.

I quickly found the clinic, and wound my way through the crowds of new soldiers, all waiting to have their arrival checks. It was quickly clear that there would be a lot to improve in this clinic – the thick grime on the door handle to the treatment room gave the impression that no one had EVER cleaned it – by the looks of shock when I pointed it out to the staff some days later, I have come to the conclusion that the impression was correct.

My room is, of course, a caravan, but a relatively nice one – I share it with the Dentist and mental health officer (a very useful guy; thanks to his existence, I don’t need to see the depressions, suicidal ideations and psychoses, all of which would take up my entire working day and prevent me treating anyone else – the mental trauma of coming to the army means that a lot of people go through at least some level of emotional distress). As a result, the room is relatively clean, and has over the years been developed into a bachelor pad – dart board, TV, fridge, kettle... even real beds brought by my predecessors and then left behind.

The toilets are quite an experience – I’m blessed to be one of the elite few who can use the officers’ toilets... but that isn’t saying so much. I truly don’t understand how people manage to create such utter squalor in such a short time – from the sinks blocked with toilet paper, to the faeces in the showers, the tap snapped off the wall and so on. The kitchens are pretty good (with one exception... read on), but the dining rooms are appalling, with kitchen staff demonstrating a lack of a single synapse – they will put out a tray of food (sausages for example), carefully prepared in the army’s strict sanitary conditions, but will not think to put a serving implement in. Then, when a hundred soldiers come in from the field without washing their hands (because their commander is too lazy or stupid to point out to the lazy or stupid soldiers that it’s lazy and stupid not to wash hands when you’ve been crawling around in a field with wild animals), they pick up their food with their bare hands. Worse, they may fish around to find a better sausage, contaminating everyone else’s food simultaneously. But it doesn’t really matter – the swarms of flies who turn up for every meal time make sure to spread the diseases just as efficiently – and the kitchen staff are too lazy or stupid to request a spring be put on the door so it doesn’t remain open for the flies to come in.

The Health Inspector

There is one person appointed to look after all aspects of public health on the base – he does a daily inspection of the base, and needs to report hygiene issues before problems arise. Unfortunately, in my life I have never met a less adept person. In a base full of hundreds of pompous, overconfident soldiers and arrogant captains and commanders, an introverted Ukrainian immigrant of 20 years old, mentally incapable of functioning in any sort of emergency capacity was dumped into a role that some logistics manager somewhere else erroneously felt was unimportant enough that it wouldn't matter if he was incompetent. For months, the situation has been deteriorating on the base, the rates of disease rising, and no one doing anything about it. That is, until the new OCD doctor arrived...

Don’t have a cow, man!

One of the many little annoyances on the base are the wild cats and dogs who have made the base their home – with a plentiful supply of food from soldiers who throw food on the floor, or don’t bother to close bins, the base makes a nice little place to live. Unfortunately, conflicts regularly arise between soldiers and animals, and not necessarily through the usual Israeli mentality of treating the cats like vermin. Many soldiers have come to me with bites and scratches, either when trying to feed the animals (which is a punishable offence) or by random encounters – like opening a bin to find a petrified cat inside, or running around a corner to find that a dog is running in the opposite direction. Every single time, I need to refer to the soldier to the ministry of health for a rabies evaluation, and to complete forms on the exact circumstances of the incident. I decided to try and pre-empt this problem by requesting from the senior commander of the base that we get rid of them. The conversation went like this...

Commander: Well, we’ve had a few gather-ups in the past, where we take them all out of the base; it’s fine for a while but we always get another load back eventually.

Adam: Well, how do they get back in?

Commander: Through holes in the fence!

Adam: Isn’t it a bit concerning that we have holes in the fence big enough for dogs to get through, when we’re 10km from Nablus (a hotbed for Palestinian Terrorists)

Commander: [Looking at Adam with confusion] I take it you haven’t seen the cows then...

(Note: I’m assured that the fence has been fixed before publishing this on the internet)

Building a more efficient leadership dynamic

I expect by now you’re getting a good picture of the nature of the base, and the army in general – there are many people who lack initiative, but more importantly, many more who have initiative but no chance to put it to any use. Only a truly motivated commander wants to have a busybody newcomer making suggestions for things which have no obvious immediate benefit, but that take time, effort, or money. Why fix a fence when no one’s tried to get through it in a long time? What does it matter to him if I have more forms to fill in because of animal scratches that are probably harmless? Why put soap by the sinks when it’ll only get used and then need to be replaced again?

The perfect example of this, to my sorrow, is the expulsion of one of my better medics – his platoon commanders (all aged around 21) felt he was taking too many people to see the doctor, and disrupting too much training by giving people exemptions while waiting to see me. From the medical point of view, if someone has a suspected stress fracture for example (something very common in the army), then it is vastly preferable to give them rest, see if the pain subsides, and assess them again, rather than irradiate them and find nothing. From the commanders’ point of view, they would much rather the soldiers trained until the last moment, and only when in agony, get checked out. The result is that most soldiers would be fine, but the small number with real stress fractures would then require such a long recovery period that they may not be able to complete their training. So, they deal with the problem in the way that bests suits them – remove the good medic and bring a more timid one, who won’t stand up to the commanders, and will request fewer appointments with the doctor. It also means less work for me, but a real chance that more soldiers will suffer more significant medical problems.

And so it suddenly becomes clear – people who are more incompetent, lazier, more obedient and less forward thinking have a better chance of staying in their position and ascending the ranks of the army.

There are, however, exceptions to every rule. Our new deputy commander is one of them.

The commanders of the base are actual adults, not hyped-up 21 year olds with big egos. In their 30s and above, they have in their 15 years or more of experience all served in wars, commanded combat units and battalions, before eventually rising to the level of the training base. As a rule, they have an air of authority and command respect. Each one will decide for himself how to conduct business with the senior staff – some remain ‘at distance’, meaning I call him commander, he calls me doctor, some will be on first name terms and call you in for a coffee and a chat. The deputy commander’s role is to basically do all the crap the commander doesn’t want to – logistics, maintenance, disciplinary issues etc.

As a fellow newcomer, I decided that the deputy might be a good person to approach to try and sort out the appalling lack of sanitation on the base, before the next epidemic. Straight-faced, permanently serious and quite abrupt, he struck me as someone who took his job very seriously. As we sat and I reeled off a list of the urgent repairs and basic requirements that were lacking on the base, his listened intently and wrote every single thing down. At the end, rather than negotiate with me what I felt was really important and what could wait, he immediately started to sort things out – the public health soldier who doesn’t seem to do anything was pulled in for a meeting with us both, an inspection of all the areas I’d mentioned was arranged, and deadlines were agreed for fixing the issues. I couldn’t believe it – someone in the army, in a senior position, expressed motivation, authority, intelligence, and most of all, genuine concern for his troops.

Unfortunately, his level of commitment to the rules and responsibilities stands on every single level; little perks that were acceptable with his predecessor are no longer okay – if I miss the bus home because of a sick patient, previous commanders would allow the ambulance to take me to another bus stop to get a different bus (rather than wait hours for the next one). This commander does not feel that is a good enough reason to dispatch the ambulance, even if it means I may not get home. On the one hand, he’s quite right – the ambulance isn’t a taxi. On the other hand, GIVE ME A BREAK! It’s a ten minute drive, and if they need the ambulance, then it’d already have a full staff.

Shabbat in the Army

Two weeks ago I experienced my first Shabbat in the army – that is, the first weekend I spent on base, on standby in case of war or major incident. The workload is very variable – it could be totally silent, looking after the relatively small number of soldiers remaining on the base that particular weekend, or it could be chaos, as the only ambulance ready and waiting in a large area.

The weekend started with a briefing Thursday night where each division (medicine, logistics, catering etc) presented their plans for the weekend – naturally, 80% of the meeting revolved around food. The main issue was due to the fact that the majority of soldiers present belong to Netzach Yehuda (I’m going to write a whole section on them in time – although they deserve a book for the amount of chaos they create) – a strictly religious platoon for soldiers who have taken on themselves the highest level of orthodoxy; as a result, they have a super-kosher dining room, prayer-time built into the timetable three times a day, compulsory fasting on fast days (where everyone else has free choice), and a total absence of women in every aspect of their army service – they require a male doctor for example (although I know of no place in Judaism where modesty overrides preservation of health). The blind decision was made by the kitchen staff that  for Shabbat all food would be prepared and served in the Netzach compound (they have their own fence to ensure a full separation), and the regular soldiers would go there to eat. A small level of insight would have ensured they would therefore check that there would be no women on the base, who would as a result have nowhere to eat... but of course that was not the case, my medic was a female soldier, as were several other staff that Shabbat. The commanders of Netzach would not even agree to allow the women in to collect takeaway food (which I would have vetoed regardless – the idea of isolating a few soldiers from everyone else on Shabbat, a time when everyone eats and relaxes together, was physically repulsive and in my opinion a disgrace). Eventually, a compromise was made – two dining rooms would open, one for the super-religious, and one for everyone else.

Alongside the driver, the medic and a major incident coordinator, I had fun making the most of the potential free time; the plan was to spend the Friday having a drive around the region as a ‘getting to know the region’ tour: as our standby could require driving to anywhere, including Nablus (where we treat Palestinians after traffic accidents etc), the local settlements and Bedouin tent villages, and all the roads in-between, it makes sense that I should know the names and locations of key sites and flashpoints. The fact that a nearby settlement had a beautiful outdoor swimming pool that was free for soldiers was beside the point entirely and absolutely not the reason we wanted to get out of the arid, feculent base. Honestly. Ahem. In the absence of the clinic commander, the deputy commander of the entire base was the only person who could authorise the trip – and once again his dedication to the mission threatened to throw a spanner in the works – calling us in for a meeting, we had to present not only the reason for the trip, but a full specific itinerary of precisely where we would go, where we would turn around, how long the trip was expected to last, and agree to make no stops, to enter no other army bases, nor to enter any settlements. The purpose of these rules is still beyond me, given that the result of the trip was a ready ambulance, full of staff patrolling the exact area it was serving, rather than having a staff dispersed across the base, and an ambulance unattended.

Somehow, despite not leaving our ambulance during the trip at any point, we returned happy, relaxed, and all an unusual shade of sunshine glow.

Friday night is the highlight of Shabbat for many people – tired from a week of intense work, returning home to sit down, eat, talk and rest is a really special moment, and I was very curious to see how that atmosphere would transfer over to the army. Entering the usually revolting dining room, I was amazed at how the Shabbat atmosphere permeates everything – the tables were all set, salads and drinks on the tables, challah (Shabbat bread) ready on the table. Around 100 soldiers were eating with us, most of whom weren’t religious (the very religious ones having been isolated). Nonetheless, the respect for Shabbat was profound – no one started to eat – everyone waited without being told until the last people had arrived – I was ‘voted’ by way of shouting ‘The Doctor!’ by the soldiers to make Kiddush and hamotzi (the blessings over wine and bread), which was quite a privilege in the presence several far more senior commanders, and a good number of soldiers far more religious than me. Arrogant and pretentious as it sounds, it was nice to feel that my work is appreciated by the soldiers I treat, even though they often seem so irritated that I didn’t send them home or discharge them from the army. Thankfully, the deputy commander sitting directly opposite didn’t seem to notice our red glowing poolside faces.

The rest of Shabbat passed smoothly, and uneventfully – meaning that I was almost ready to enter the next week of insanely busy work, despite having only had 12 hours to see my lovely wife.

Deborah's bit

Meanwhile, back at home Deborah’s concerns about the competition building at work between Israel and Manila proved to be well founded – she’s now in her last few days of work on the projects and feels deflated and disappointed. Personally, I think the timing is wonderful. The job came along at a perfect moment in Deborah’s life, where she needed to adjust to life in Israel, while simultaneously losing her husband to the army. It gave her freedom to work as she wanted, while being available to sort out our mortgage, and to adapt to the new lifestyle. And the job has continued up to just a few weeks before she takes her first steps as a hospital pharmacist in Israel, after some freedom to refresh her knowledge and get ready for the next big step. It’s never easy losing a job, but if it has to happen, the timing couldn’t be much better. And she made sure to get her complimentary Rosh Hashanah present from the office before she leaves. That’s the most important thing.

Life in the armpit of nowhere

After four months of living together, working together, sleeping in the classroom together, sleeping in armoured personnel carriers together, and playing on iPhones together, our group has finally split. As you’ve seen from the previous blog entries, it hasn’t always been easy. Sometimes, in fact, it’s been really difficult. Coping with a high pace of learning in a foreign language with people in the top 0.5% of the population in terms of IQ (a pre-requisite for them getting scholarships for medical school from the army), while not getting enough sleep, and living next to the Georgian soldier whose personal hygiene and eating habits are possibly the cause of most new species of bacteria discovered in the past century, has not always been an enjoyable experience. 18 hours days followed by a weekend poring over reams of small-print Hebrew medical and military literature has at the very least been as difficult as University, and probably more so with my old and tired brain.

Getting to the end of the course was certainly not a sad moment. Of course, it was tough to say goodbye to the people who had effectively been my friends and family for the past four months, but as we expect to see each other at various conferences, mass casualty incidents, and wars, it was more of a ‘lehitraot’ (see you soon), than a ‘shalom’ (goodbye).

Graduation

The end of the course arrived and we celebrated with a fancy graduation ceremony. Family, friends, the surgeon general of the army, various commanders, and all the ecstatic people who we would shortly be replacing, came to celebrate the end of our training.

The IDF, like most militaries in the world, holds discipline and efficiency in high regard. Unlike most militaries in the world, the IDF tends not to actually do very much to encourage either. On the one hand, it makes sense that we spend our time learning military skills and medicine, rather than learning how to march in perfect unison. On the other hand, when a number of soldiers (including several seemingly dyspraxic ones) march for the first time in their lives 24 hours before their graduation ceremony (pretty much the only time 99% of soldiers will ever actually march anywhere), it’s inevitable that the outcome will not be impressive.

With hundreds of guests lining the yard (including Deborah, my cousins Beryl, Pinchas and Dina, and Deborah’s auntie Paula), we took to the march, in time to a very nice recording of some generic military marching music presumably recorded some decades ago when the IDF still used military orchestras. In true Dad’s Army style, we set off – some on the left, some on the right – some hopping on one leg until they could figure out which one everyone else was using. Having received our new berets just a short time before the course (in my case about three minutes before – each battalion has its own colour scheme, and therefore each doctor had to arrange somehow for someone to deliver the appropriate uniform in time for the ceremony), most had their beret leaning to the right, one or two to the left. Some were completely devoid of rhythm finishing one step behind everyone else. But, it looked okay in the pictures, and ultimately, unison marching simply wasn’t the point of our course.

So, after some considerable time standing in the Israeli summer sun in full uniform, with a thick wool cap on my head, listening to various speeches and pep-talks about how great we all are, (why they didn’t just say dulce et decorum est, I do not know), we patronised the audience with some formation marching creating words like ‘Thanks’, ‘IDF’, ‘Medical Officer’, and finishing with a somewhat deformed Star of David, before throwing our berets in the air in cheesy American-college-graduation-style fashion.

With that, our course was complete, and Deborah and I departed on a week of compulsory holiday (where the army forces you to take leave at a moment convenient for them, so that you won’t ask to take it at a later date that doesn’t suit them entirely). In a remarkably small time, we managed to pack in a lot of fun – hiking in the Galilee, camping in the Golan Heights, white water rafting on the Hatzbani, eating in posh restaurants on the riverside, picking avocados on the roadside, swimming in the sea of Galillee and a bit of compulsory DIY in the few remaining days.

Up until a few days before the end of the course, none of us knew where we would be based for the next 14 months. Many of us wanted to head to infantry units, where we would be isolated, involved in the management of military operations, logistics, hygiene on base, wartime preparations, and once in a while a little bit of medicine. Many wanted an easy life where they could work 9-5 in a cushy clinic near mummy and daddy. Some wanted a nice in-between, and that is precisely what I went for and what I supposedly got. I was proud to be appointed the doctor of ‘Kfir’ training base, the home of one of the IDF’s anti-terrorism battalions, and as such, will spend the next year of my life with the hundreds of soldiers starting out on the course of a fighter.

Arriving to the base for the first time was in itself an experience. Based very, very deep in the West Bank, I was expecting a veritable fortress surrounded by enemy eyes – and was amazed to see that the reality was very different indeed. As my bus wound its way through the hills of the Judea, starting in Jerusalem and heading North East, I realised just how utterly desolate the West Bank is – with the exception of a few clusters of tents of the resident Bedouin population, still living without electricity (except the occasional generator), and a handful of green Israeli settlements, there really is nothing here. In fact, I’m writing this while on the bus home, and right now I’m stopped at an army base on a hill top – I can see miles in every direction, and there is simply nothing here. No roads, no infrastructure, no villages, nothing except barren yellow hills; just as the whole region was before the pioneers of the 19^th and 20^th centuries created Israel.

Eventually, we arrived at the base, surrounded on all sides by hills, with no sign of human habitation outside of the base except our over-ground water pipe, serving the base with 50 degree water throughout the day, and a suspiciously placed Bedouin tent-village, conveniently in easy reach of said water pipe.

By coincidence, my first day on the base, was also the first day of most of the new influx of recruits, who were arriving throughout the morning. As I entered the base, I saw a mix of excitement (in the 1% of the population who had dreamed of this day since childhood), and sheer panic and depression (among the 99% of the recruits who hadn’t yet left childhood). Hundreds of children in green uniform roamed the base before me, not knowing where they were meant to be, many away from home for the first time in their lives, some scared to use the toilets or drink the hot water, many on the verge of tears because the phone signal in our valley is too poor to check Facebook some of the time. As I tried to find my clinic, weaving through the kids, the excruciating heat bringing tears to my eyes, I realised that my placement may not be as straightforward as I had anticipated.

I had had some very noble plans for my arrival at the base. I even made a list of things to do and when.
- Face to face meeting with each medic – get to know them, explain my ideas for the efficient management of the clinic and hear their concerns
- Tour of the base – learn where things are, useful contacts, emergency protocols, evacuation routes
- Tour of the area – learn where our neighbours are, where our enemies are, what danger spots are present
- Meet the commander of the base and talk through my role
- Face to face meeting with the doctor from the sister base a few kilometres away (more on that in due course)
- Face to face meeting with the commander of each platoon to make introductions.

As the saying goes, the best laid schemes yada yada. Within 4 hours of my arrival, I had abandoned all hope of complete most of my goals, at least in the near future. Instead, I was sitting at a desk seeing my first patients, working with a computer program which would be infuriating at the best of times, even more so due to the fact that when we had had our training session on how to use this program, there had been a catastrophic failure of the entire computer network. Trying to differentiate between patients, I could categorise them into the following:

- Panic attack
- Fake panic attack
- Fake medical condition (doesn’t want to be here, ‘Motivation Zero’)
- Fake medical condition (wants to be here, mummy doesn’t want him to be here, instructed him to write ‘Rare Bowel Disorder’ on his medical declaration)
- Joint pain which bizarrely started after a 40km hike with a 30kg back pack
- Serious medical condition (that absolutely should not have made it to an elite fighting unit, but somehow managed to slip through a hole in the net big enough that a dead terrorist with one leg would get through)

Throughout each day, the timetable is fairly standard – I see routine cases in a supposedly organised fashion from 0830 until 1800. Of course, at the same time, I’m permanently on stand-by for emergencies; so many times have I been in the middle of dealing with a patient with, for example, diarrhoea, when the alert comes in for a suspected heat stroke. Everything stops, I run to the emergency room (which is literally that, not a big fancy department, but another little room in a little caravan, with a bed and a few drugs in it... and the obligatory rectal thermometer – both a diagnostic tool and a preventative measure against soldiers faking heat stroke – and we wait for the soldier to be carried in on a stretcher by another four soldiers who have just run across the baking desert to bring him to me. Many times have I wondered how many soldiers suffer from heat stroke as a result of running to bring in a soldier suffering from heat stroke.

Inevitably, every day, my clinics run late because of cases like this. So I’m lucky to finish my clinical day before 2000. Then of course, I start the paper work, blood result processing, letter writing, follow up of difficult cases, and so on – all in Hebrew, and all on a fantastically slow computer running an intricate and temperamental computer program. Needless to say, the emergencies carry on throughout the night and as I also cover the region’s roads (our ambulance is the only emergency vehicle permanently on standby in the region), there are plenty of urgent things to do. This week saw a lorry fall off the road, three scorpion stings (including two, yes two, to soldiers’ heads – learning to sleep in the desert isn’t instinctive), anaphylaxis after a hornet sting, and a school bus of children that had rolled over. The anaphylaxis and the school bus were in fact false alarms (because people are stupid), but nonetheless resulted in all the stress and panic of emergency situations until proven otherwise. So, all in all I’m lucky to work less than an 18 hour day.

As the weeks have passed, many of the most problematic soldiers have been excreted from the base, to my immense joy. The logic of keeping a soldier who doesn’t want to be here defies me – the odds of such a person developing into a champion of the battlefield are slim to nil, and through his 8 months as my patient, he is likely to return time and again with aches and pains, various complaints, requests for referrals – anything he can think of to get out of our baking-hot caravan park in the middle of nowhere. So slowly but surely, the work load seems to be slowing. Most nights are undisturbed, and having learned which of my medics are fantastic and which ones are utterly inept, I can now filter the ‘emergency’ phone calls at 3am, knowing when to trust the medic and run, or when to grill the medic with a list of questions to whittle down the diagnosis from ‘massive arterial haemorrhage’ to ‘cut finger on piece of paper’.

I’m not alone on the base, although it often feels like it. Technically, there are four ‘senior treaters’ between two big bases – one paramedic, and three doctors. Paramedics are a fairly new investment in the army – people (usually women) who are trained up to be fully qualified paramedics in a relatively short time, in exchange for selling their souls to the army (much like the apprentice doctors who learned medicine for free in exchange for working like a dog without a salary for the next several years). The paramedic is there as an emergency on call resource – either when there is more than one emergency simultaneously, or when I’m not around for another reason. The problem is she also covers the other base, and various training exercises in the region. So, it’s rare she’s actually here, and even rarer that I or my medics know she’s around – and therefore the work still falls on me. In addition there’s technically a second doctor here – the commander of the clinic – a women who outranks me and can order me around, and who is leaving in 2 months. As a result, she seems to treat a remarkably small number of people, doesn’t split up the ‘days off’ evenly between us, but like most bosses, seems willing to take credit for anything good that happens under her authority. The big question is who will come to replace her? A good hard-working doctor who believes that work should be split evenly would effectively half my workload, but only time will tell.

Of course, the hardest aspect of the entire experience is the lack of time I get to spend with Deborah, who continues with her editing work. It’s a great job in terms of its flexibility (working from home and choosing her own hours and to an extent the amount of work she takes on), but results in day after day home alone. Soon, Debs will start working as a pharmacist in Shaarei Tzedek, one of the best hospitals in the country, and so we are both looking forward to her getting back into her vocation. But in the meantime, she continues to write and edit Q&As on obscure medical topics, such as ‘What is the best type of shoe for someone with Crohn’s disease to wear’ or ‘How many times a day should someone with eczema need to take a pee’. The work is divided up among a few editors in Israel, supervised by a regional manager, and super-supervised by a big-wig manager in the USA. At the same time, another office in the Far East does similar work for far less money, but with far more heinous errors in the English. So a stressful competition has developed between the two centres, each trying to achieve better results in less time and with no guarantees of long-term job security. As far as I’m concerned, Debs should sit back and enjoy the ride, in the knowledge that she has a pharmacy job just around corner (covering maternity leave for someone who should be due to pop in a few weeks), but being the good conscientious worker that she is, and keeping in mind the possibility that she may work two simultaneous jobs (neither being full time), she’s getting sufficiently stressed to keep our blood pressures up.

As my only time to write the blog is now during bus journeys, I must sign off now – no more battery. But there’s a lot more to tell – hopefully in the next installment...

M*A*S*H

It was tough. Possibly the toughest thing I’ve done. 4 months of:

- 18 hour days – waking up at 6am to clean the toilets that had been made revolting by other courses (most of the doctors on the course are sufficiently OCD to ensure that the toilets remained more or less a uniform colour)

- Mind-numbing lectures, entirely in Hebrew – for example, our two-day course on occupational medicine, learning all about how to distinguish chromium poisoning from cobalt poisoning, just in case someone decides to start mining underneath the base and storing heavy metals in their bedroom.

- Atrocious food - really, atrocious - I’m not a fussy eater, but somehow they managed to make even the humble cucumber revolting by either leaving in the sun too long, preserving it in what I can only assume was formaldehyde, or drowning it in garlic salt). Want a boiled egg? No problem. But it came from a chicken who probably died in 2008, and has since been gamma irradiated and stored in an airtight jar in a hot warehouse. If the odd bitter taste and slight black colour of the yoke doesn’t put you off, the botulism will. Don’t get me started on the scrambled egg (from egg powder) or the shakshuka (from egg powder)... or the soup (from soup powder), the potato mash (from potato powder) or the salad (from salad powder... probably).

- Commanders who did their best but were ultimately little kids on power trips. Some of them were great – the overall boss was a doctor whose experience justified his role. But most were age 21 or so, just about managing to grow some stubble, and lacked a hint of common sense. Like the time I was reprimanded for checking my gun was safe and unloaded before returning it to the warehouse (as is obligatory), because I hadn’t been ordered to, and because the commander (and everyone else) had forgotten about it.

- Exams – exam to assess trauma care = fair enough. Exam to assess communication skills = fair enough. Exam to assess ability to deploy a field hospital = fair enough. Exam to assess the differences between different types of helicopter = borderline. Exam to assess the understanding of legal obligations of the state and army after a soldier is exposed to a trace of asbestos = pushing it. Exam to assess details of what to do in the event that our field hospital is attacked by various methods = scary. Week in, week out, exams. Some logical, some medical, some based on out-of-date 200 page books about the old army structure, which we must still be examined on because no-one has been bothered to make an updated version with the correct information in it. So I know all about the central care clinics of the old days, but as they don’t exist anymore, no one has checked if I know how it’ll work in the next war.

- Life in the field. The big field exercise is a blog entry in itself. So much to say... see below.

- Army mentality. It would be unfair to say that the army was more ridiculous and irrational than every other organisation and company in Israel. It isn’t; it’s just that the army is so big, all of that ridiculousness is confounded. For example, not long ago I required a new felt tip board marker during a classroom exercise; having discovered that such a valuable commodity was not kept in supply in the classroom cupboard, I went over to the logistics department to get another one. After a 5 minute debate, I left empty handed; unless I could return the empty old one (to prove I did indeed need it for classroom activity), I would only get a new one if I had attained the rank of lieutenant or higher. In addition, here are the three golden rules of the army that apply at all times.

- The law of time

It’s reasonable that punctuality is important both to ensure efficiency, and discipline. But what happens if one completes the task early? This is something that we experienced many times; an exercise that finished early, a lecture that finished early, or even a lecturer that failed to turn up. Logic would suggest that we use the extra time to work on a different project, or move some other activity forward to allow us to finish our day earlier and get more sleep... or even go home! But the law of time suggests otherwise. It dictates that if something is due to start at 1700, it must not start earlier, as this would not comply with the law of time. If our day is due to finish at 2215, it must not finish at 2200 – as this would severely impact on the reliability of the law of time... it could have vast and never-ending consequences on...er... the law of time. Thus, the self-fulfilling prophecy of punctuality and subsequent wasted hours continues.

- Wet is clean

It’s very difficult to clean a floor that hasn’t been scrubbed in years. Grime, caked on mud (and probably excrement), and a bad paint job that means most of the floor is cheap army paint anyway, preclude any possibility of truly making the toilets feel like the risk of catching a significant disease is low. Inspections of cleaning are made immediately after the allotted cleaning time is over (needless to say, if one finished early, the law of time is activated, and one will automatically reclean the same area, to avoid the risk of being sent off to clean some other, more filthy area, until time runs out). So how can a commander know if the room has been cleaned? Simple! It would be wet! Therefore, a bucket of Israel’s precious water, flung over a toilet and the surrounding floor, and haphazardly cleared away, is sufficient to pass the commander’s inspection. Heaven forbid you wet it too early, allowing drying time, or much worse, make the effort to squeegee away all the water... as clearly, the room would therefore be dirty again.

- Being confused with police

During officers’ training, all soldiers wear blue lapel tags on their shirts. Symbolically, this represents the real officers’ lapel markings, supposedly hidden beneath, which are then exposed when the blue is ripped off by the course commander during graduation. Unfortunately, this means officers sometimes get confused with military police, the useless vermin who spend their lives giving soldiers fines for having scuffed shoes or a wonkey badge. Army doctor = loved. Soldier in officers’ training = loved. Military Police = Hated. Quite amusing to see how many people seemed to glare until they discovered I wasn’t looking to give them a ticket. (We were told a rather amusing story of a military police officer who was assaulted some years back, when he tried to give a soldier a fine for having muddy shoes. The soldier had just returned home from the immense stress of the Lebanon war, sleep deprived and physically drained; when he was stopped by the officer, he snapped. Good for him!)

Life in the field

Part of the course involves a week of very high-level strategy training. In conjunction with other courses – such as the commanders’ course, we took part in a full-scale war simulation, where Israel had (once again) been attacked by Syria. Needless to say, I’m not exactly going to publish on the net details of who, what, how, why, where... or in fact anything else that bears any military significance (although Syria probably know all that anyway), but I do want to tell you about...er...being close to nature.

After days of preparation, planning, meetings, maps, logistics and so on, I joined a unit as their medical officer as Israel went to battle. It all started in the middle of the night, with a nice sleep out in the cold night air, underneath the stars, hoping that the scorpions weren’t feeling too pissed off and that the hypothermia would ease off when we started our moonlit hike with heavy backpacks and M16 assault rifles. It was a long trek towards a virtual enemy, through swamps, razor wire, mosquito hotspots and the small but nonetheless significant risk of taking a wrong turning and entering a minefield. We had approximately six hours to reach our destination before sunrise.

A few miles into the hike, something rather unfortunate happened. My stomach gurgled. In itself, that wasn’t such a problem. But it happened to be the battle horn of Operation ‘Adam ate something that wasn’t prepared in sanitary conditions’. After 30 minutes, my stomach was so bloated that not only had I opened my belt, but also all the buttons on my trousers, and was eyeing every tree we passed for a suitable place to...er... deploy my troops. But responsible for hundreds of soldiers, on a tight deadline which influenced the entire mission, there was no way to stop, and no way to leave the group. Onwards we trod, through the night, no end in sight and no time for a break.

A couple of hours later, luck dealt me a good hand while dealing someone else a harsh one. A vehicle in another unit overturned, leaving several injuries and resulting in a halt to the mission. We buried ourselves in the grass, silenced the radios and waited for an indefinite period, while one of my colleagues dealt with a compound fracture and arranged evacuation of the injured. My chance had arrived!

I snuck away from the group, holding my cramping stomach in one hand and a first aid kit in the other (gauze being the only option available to me...) while climbing over the rocks and tall grass to the ruins of an old building 50 metres away. It was the perfect location – open to the elements from above, but surrounded on all sides by the remnants of a wall, currently at shoulder height, offering sufficient privacy without the risk of walking into a rats den. I found my spot, began to prepare, when suddenly...

“Freeze! Identify yourself!”

Yes, of all the places, in the dozens of square miles of wilderness in which we roamed, I had chosen a spot around 5 metres away from a covert spying unit, complete with night vision, just on the other side of the low wall. Did I care? No I did not.

Some time later, feeling much happier, and lighter, we continued on our way into battle, complete with the boyish fun of real tank fire, live bullets, and helicopter evacuations of my virtual patients.

So, here I stand at the end of the course. I have been placed in a base in the middle of the wilderness between Shechem (Nablus) and the Jordan Valley, where I will spend the vast majority of the next year of my life. More to follow soon...

It’s medicine, captain, but not as we know it

Just over a month ago, I reached the end of tironut, or basic training. It had been a few weeks of not-so-intensive learning, nearly edible food, and teenagers dressed in khakis carrying M16 assault rifles around. We had lectures such as ‘why are drugs bad for you’, and ‘sexual assault: naughty naughty’, and we came to terms with the arduous task of cleaning up the squalor of the animals who share our base. We ended with a passing-out ceremony which, due to the size of our platoon (6 people), felt more like an intimate meeting with the boss than a pledge of allegiance to the state.

The next week, we moved on to the juicy stuff – starting with ATLS (Advanced Trauma Life Support) course – a world-wide programme run to a set syllabus, taught in the lovely fluffy western ‘criticism sandwich’ style, with phrases like ‘you did that procedure very well, but next time try to put the needle in his chest, not his eyeball...but otherwise it was very good’, or ‘I liked the way you intubated the patient, but traditionally we tend to only do that when the head is still attached to the body. Although your approach is still very valid’.

Gradually, we moved on to the Israeli adaptations – specifically, MTLS (Military Trauma Life Support) – essentially the same idea, but geared more to the realities of military medicine. Suddenly, the scenarios we faced changed from a driver who fell asleep at the wheel to a platoon of soldiers who had been ambushed and were spread over a wide area, with a combination of gunshot wounds, blast injuries and external bleeding... while taking into account the possibility that a Palestinian terrorist is still looking at you down the barrel of a gun. The pressure thus increased tenfold, and the learning curve began to steepen.

After one week of super-intensive trauma learning, we began “carap sadir”, the acronym meaning “Regular Medical Officers’ course”, the course that will occupy my time between now and the summer, with an array of different things to cover. Of course, there’s been (and will be) plenty more trauma learning, but at the same time, there’s a lot more medicine to learn too – how to write sick notes, how to prescribe paracetamol to a soldier pretending to have a headache, and how to tell the difference between a haemorrhage and ketchup. But besides from the medicine, seriously, there is an insurmountable amount of additional knowledge to take in. Ultimately, the role of a combat doctor is extremely broad. Aside from treating the injured people (on both sides, incidentally), we also play a large part in deciding evacuation routes, locations of field hospitals, helipads and safepoints, as well as all the training of medics and first aiders, public health and vaccinations... we’re even responsible for testing the water each day (after a tactic in recent years of poisoning soldiers with arsenic). So, in addition to learning how to deploy a medical unit, how to stock and maintain an armoured personnel carrier, and how to triage a mass casualty event, we are undergoing training in navigation, topography, communication and all sorts of other things which I unfortunately can’t elaborate on. Which is a real pity, because it’d make the blog extremely interesting.

The biggest issue is without question the language. Having coped pretty well for over half a year working in Hebrew, I didn’t expect the army to be that much tougher than I was used to already. But, as it happens, the army doesn’t speak Hebrew... it speaks Army Hebrew, which is worthy of a whole dictionary to itself. The number of abbreviations in daily use is just incredible. Unfortunately, I can’t give specific examples on t’interweb, but I’ll attempt to create the atmosphere through English. I’m not a doctor. I’m a Umo (Unit medical officer), and I don’t work in a clinic, I work in an Ugs (Unit gathering station). One of my jobs as a Umo is to maintain the Fog (forward observation group) which, if in one place for some time, is known as a Fos (Fog static). My CM (chief medic) is responsible for maintaining the mass (medical supplies). My boss, the Imo (Important medical officer) answers to the Chmo (Chief medical officer), who is the boss of Mad (medical division). So, if there are any problems with the fos – let’s say that the fog needs some more mass but the CM is a lazy AH, and so it isn’t fit to be classed as a fos at all, then the umo should probably speak to the chmo, via the imo, assuming that when the umo sat with the cm, no good outcome was achieved.

NOW, imagine all that, in a foreign language, for 18 hours a day. It’s not easy. Especially when you then need to learn radio codewords for the different roles.

So, if there are any problems with the apple – let’s say that the window needs some more banana but the tissue is a lazy AH, and so it isn’t fit to be classed as a window at all, then the bottle should probably speak to the flute, via the cello, assuming that when the bottle sat with the tissue, no good outcome was achieved.

The group itself is a mixture of native Israelis and immigrants – the Israelis are all scholars – in other words, fresh out of their internship year, wet behind the ears, and setting out at the beginning of a 5 year military service (in exchange for the army funding their degrees). Most importantly, we get to come home almost every weekend, and even one evening during the week, provided we’re happy to get up at 0430 to get back to base in time. This is a significant improvement on the original terms of service, whereby I can expect to come home for two weekends a month (although this could still be the case after the course), but on the other hand, this is the first time this course has been run residentially, rather than a cushy home-each-night format. Slightly irritating when I could have been on the last course if the army had been a little bit more efficient, but at the same time, I’m glad to be with a fab group of people, and the extra half year has certainly helped my language skills.

So, what about outside of the army? Deborah continues to work from home, while tentatively starting the search for pharmacy work to get a foot in the door. Much as we hate the separation while I’m in the army, it makes the days we have together much more special (provided I’m not studying for exams, or writing a blog). But, we have some very exciting news... no, she’s not pregnant.

Last week, we signed the contract to buy our apartment! Before anything else, it’s important to stress that things work backwards here. First you sign the contract and pay a deposit. Then you get the mortgage bank to pay off the previous owner’s mortgage, and only then do we obtain possession of the apartment. So, the show isn’t over yet. But here’s the story so far...

Back in December, we were leaving our apartment to head back to the UK, when our neighbour stopped us on the stairs.

“Is your landlord selling your apartment?” asked the sweet Russian lady. “Er... not that we know of. Why?” replied the suitcase-laden British couple. “Because I just found an advert for it online”.

We called him straight away, and were reassured when he told us it was clearly a mix up, and he had no intention of selling. But, to be sure, when we got to the airport and logged on to the net, we found our apartment, with full description, and our landlord’s contact details.

To cut a long story short, he maintained the lie throughout, constantly reassuring us, and explaining that he was trying to sell his car, and the website made him put up an additional advert, so he used our apartment just for the sake of it. Sounds perfectly reasonable to me... So we asked an Israeli friend to call and enquire as an interested buyer, and the apartment was very much for sale, and apparently available immediately from the end of our lease.

Ultimately we decided to jump in at the deep end – and somehow we obtained mortgage approval, and when we told him we had a budget, suddenly his attitude changed.

“Well, I don’t want to sell it, but I’d like to help you and Deborah get settled here, so I suppose I’d sell it to you, as a favour... but don’t tell anyone else because it isn’t really on the market”.

5 months of playing his little game later, and we have signed the contracts for our first ever non-rented home. And the best bit: if all goes to plan, we won’t have to move, and we already know we love the place.

So, as we start to come to terms with our new obligation (a hefty mortgage payment each month), it just remains for me to wish you Yom Haatzmaut sameach (Happy Independence Day) – Israel is 63 years old this evening, and it is to that I owe the pleasure of a day off from the army. Israel precedes its independence day with the annual memorial day for its fallen soldiers – the dark before the dawn, as it were. As I stood among a thousand soldiers this afternoon for a minute’s silence in honour of the 25,310 Israelis who have fallen in battle and terrorism in the past 63 years, and then moved on to sing Hatikva (The national anthem), it once again sunk in that Deborah and I are living in a dream. Moreso in my current role than ever, we can make a difference. We can save human life, show compassion, and fight for something we believe in. The dream may be a tough one, more like a nightmare at times, but thank G-d things are moving forward, both in our own personal life, and as a nation, and we can’t take that for granted.

I leave you with this link; an interesting short blurb in honour of this little country’s birthday.

http://www.janglo.net/index.php?option=com_adsmanager&page=display&catid=99&tid=145876&utm_source=MadMimi&utm_medium=email&utm_content=Janglo%3A+Independence+and+Greatness&utm_campaign=Janglo%3A+Independence+and+Greatness&utm_term=See+Janglo_27s+full+article+in+honor+of+Yom+Haatzmaut

One month in – life in the IDF

Today marks the one month anniversary of the day I put on my uniform for the first time and stopped being a civilian. I'm sure my last post, just a short time before I said goodbye to Deborah and headed off to a complete unknown, expressed the fear and anxiety we were both feeling; I felt as though we were facing a giant grey wall, no idea what would be on the other side, where life would head, what would happen. A mix of excitement at reaching a stage I had been anticipating for years, and doubt caused by the myriad of stories and experiences our friends and the media prepared us for. From the pointless menial tasks (like sweeping a sandy floor before stacking sandbags on it), to the gruelling physical exercise, to the appalling food, the overall impression given to us was hardly a positive one. In addition, I was, on some level, distracted by doubts about the ethics of being in the army. Pro-Israel activists always stand by the army in every way; whenever there is a civilian casualty or death, they can always provide some justification or explanation, while on the other hand, the Anti-Israel activists will always lambast the IDF and everything associated with it – such as the UN report condemning Israel and Hamas jointly for war crimes during Operation Cast Lead in Gaza. It so happens that just this week, the writer of the UN report has retracted his condemnation (http://www.bbc.co.uk/news/world-middle-east-12949016), but for the past year, many people including myself, have wondered to ourselves, "Is this really bias against Israel, or is the IDF really committing atrocities?". In short, entering the army and seeing the truth, with my own eyes, without doubt about misinformation, could make me prouder than ever to be part of this country, or could shake me to my core.

My Tzav Hityatzvut, or call-up order, was for March 8^th 2011. The letter told me a place, a time, and various things to bring, like running gear, while also requesting that I shave my head, bring a bank card, and take note of what the army would provide me with, so I can fill in the gaps (we get socks, but not underwear; they provide T shirts, but only two of them, which is hardly enough for living on base a week at a time). So, before 6am, Deborah and I set off for my 7am arrival at Givat Hatachmoshet. We were among the first arrivals, but it soon became apparent that I was the only guy – of the hundreds of people attending the centre that day to be shipped off to Bakum (see below), the average age was 19, and every single person was a girl. We were slowly processed, and I was pleased to find a single other male, who also appeared to be significantly older than the rest of the group. As it later turned out, we were the two Jerusalem doctors being drafted that day; the other guy, Ilia from Georgia, has ever since been a roommate (and I will fill in those stories as the blog progresses).

One long coach journey later, we arrived at Bakum, a massive army centre where every new recruit passes along a factory production line going through various tests and interviews, such as dental photos and X rays, DNA testing, vaccinations, financial interviews, finger and hand print recording, and basically every other imaginable test available in order to identify/incriminate us in case of need. We were assigned our uniform, including rigidly uncomfortable boots and unhemmed trousers (the secret is to use an elastic band at the bottom of each leg and tuck the end of the trousers in; so they will always be the correct length). Gradually, more and more older-looking men gravitated together, and by the end of the day, a small group of 6 immigrant doctors had formed, from UK, US, Australia, Russia, Georgia, and Ukraine. We were piled on to a bus with various other soldiers heading off to their various destinations, and eventually arrived at our new home; the headquarters of training for the medical corps. Straight off the bus, we were greeted by the commanders of our basic training.

Basic training in the IDF is a very broad term, covering everything from intensive courses lasting several months, with gruelling hikes and complex training at one end, and our basic training at the other. Consisting of a few weeks of mild-mannered lectures, teaching us that drugs are bad, sexual assault is bad, Syria is bad, and army food is good, combined with a few Dad's army style runs and push-up sessions, I didn't exactly find the training to be one of the most challenging eras of my life. But, the decision to give us a gentle intro was a conscious one, based on the relative old-age of our group (24 - 32 years old). However, there is one common feature throughout all basic training in the IDF. Distance.

Distance is the phrase used to describe the act of separation between the cadets and their commanders. It dictates that commanders are always treated with respect, are never referred to by name, and must always be addressed with 'yes commander', 'no commander' or 'three bags full commander'. They are never allowed to joke with us or smile, and can never chat informally with us, until the end of basic training, and the 'breaking of distance'. Sounds reasonable? It would be, except that our commanders were all 19 year old girls. They were, in fairness, very good at their jobs, knowledgeable and confident, and seemingly undaunted by the fact that they were disciplining people who weren't far off twice their age. Most of them were actually very sensible with their approach towards us, in essence explaining to us early on that they know we aren't 18 year old Israeli brats who need a kick us the arse to learn a little discipline, but mature adults who have clearly already learned how to work hard and who have some level of knowledge regarding Israeli culture, given that we have graduated, survived on-calls, and chosen to move to a foreign country. But, predictably, there were also those who played their role to the letter. The most significant example of this was during a lecture off-base. Having finished two hours in a lecture room, we were ordered to make our way to the waiting bus for the hour-long journey home. Using our grown-up initiative, we decided that a quick visit to the bathroom en-route would be prudent, and arrived at the bus ready to go, perhaps 90 seconds later than they estimated. We were reprimanded and told that it was not our place to decide when to go to the bathroom. We should have reported to the bus, waited for our commander, requested approval to go to the bathroom, then, assuming approval would have been granted, headed back into the building, battling against the crowds of people leaving the lecture, to head back upstairs, to the now-fully-occupied toilets. The conclusion – basic training is simply not the place for independent thought or common sense.

After 3 weeks of such discipline, combined with exams checking that we knew which ends of our M16's to look down, we graduated from basic training. This normally very powerful ceremony, where we pledge our allegiance to the state and to the armed forces, to uphold democracy and the values of the IDF, is overseen by a high-ranking commander and normally takes place under the Israeli flag, attended by hundreds of soldiers, family and friends. But when your basic training is so specific as to cater only for new immigrant doctors, the power of hearing dozens of voices reciting the pledge of allegiance is replaced by the humour of hearing a tiny group of people each reciting the pledge in their own foreign accent twangs.

After the ceremony came the all-important breaking-of-distance moment, where our commanders suddenly become our friends, smile and chat, and flirt. That'd be great if we were the usual 18 year old guys passing out, but for most of us, the commanders simply metamorphosed from kids dressed up as commanders, to just... kids.

Six old men, six olim, six doctors, from six different countries, ready to move on once more, but this time with a greater understanding of the massive, sluggish, irrational machine that is the IDF.

Basic training has not been the most challenging time of my life; in fact it's felt like a nice, gentle introductory tour of the army, letting us get a taste of the things to come. It's completely eradicated some of the major fears that come with army service (although, of course, not all), and even after a month, seeing myself in uniform, wearing the tags of the medical corps, gives me a strong surge of pride. I am truly starting on a path that will make me an Israeli, and give me a chance to contribute to a cause I really believe in,

This time, I'm not heading into the unknown quite so much. Just moving forward.

The end of life as we know it

Time doesn't ever seem to get any slower, and it's truly scary to realise just how much time I've let slip since my last blog update. Each day flies by, even the ones where I look back and ask myself 'What did I achieve today', and don't answer because I know the reply will make me more frustrated.

Little wonder then, that the blog has fallen behind. In truth, there's a lot to tell, although I'm not sure how much is blog-worthy; but as the ultimate intention of writing the blog was not to make a sensational novel, rather to make a record of the trials and tribulations of aliyah, both for ourselves, and for those who may one day follow in our footsteps, I suppose I'll endeavour to plod on.

I'm writing this on a plane, on the way back to Israel after an impromptu visit to the UK for the unexpected funeral of my uncle Leon z"l. I truly stand at a turning point in life, and the emotions and feelings that course through me are profound. In five days' time, I will commence my 18 months of service in the Israel Defence Force.

This is a moment I have dreamed of for a decade; to be part of something I believe in; to live and work and fight for something bigger and greater than me or my future; to contribute to freedom, democracy and Zionism. To feel part of the pioneers who re-created the Jewish state; to protect my people and proudly proclaim 'Never Again'. For ten years, I have seen pictures, heard testimonies, read stories of life in the army, and I wouldn't let anything stand in the way of that.

Gradually, reality can creep up on you. I was under no illusions of the difficulties of life in Israel or the army, and I knew what I was letting myself in for. But what neither I nor Deborah anticipated is that our goodwill and devotion to our country may not necessarily be reciprocated, or at least may not be clearly shown.

It's several months since I turned up for my first meeting with the army - back in about November I was called into the recruitment office in Jerusalem, where a very friendly and polite child (well, perhaps 18) interviewed me on every aspect of my life, from my religious views, to my hobbies, to my kindergarten, before sending me on for a physical where a large Russian lady criticised my hairy naevi, and finally on to a psychometric exam where I had to match up the funny shapes. Some weeks later, I was summoned to the medical corps HQ near Tel Aviv; the 3 hour journey each way for a ten minute meeting in which I was told very little was somewhat frustrating, but at least I found out that I would start army service in April, giving me a chance to notify work, family and friends, and create a plan for the next few years of my life; that said, I was advised to call 2 days later to get the exact date.

2 months later, much nagging, and wasted phone calls, I was still not informed of a start date; with just 12 weeks until Passover (one of the main Jewish festivals, this year in late April), and various friends and family planning to visit, it became clear that I should cut my losses, and assume for the worst - so all flights and holidays were booked up until the end of March, just to play it safe.

When I was resummoned to the base, with a few days notice in late January, I finally got some info; a salary, details of the appalling terms of my annual leave and home leave, and a start date of March the 8th, because the stupid woman who coordinates all army doctors forgot that there was a special doctors course I needed to do first, before the normal call up date. Without apology, regret for the inconvenience and waste of money to my friends and family due to be visiting in March, I was informed that this was unchangeable. In addition, I was advised that I can expect to see Deborah every other weekend, and one evening a week for the week I don't get home at the weekend, assuming I'm close enough to Jerusalem to get home in time. Oh, and that I'm entitled to 15 days of leave each year.

In one day, it became clear to me how much life had changed; all the decisions and plans I had made before marrying Deborah, which were panning out beautifully, were no longer what I wanted in life. Feeling for the first time like a machine owned by the army, with no consideration for my personal life, let alone that of my wife, I was drained and powerless. The goodwill on my side, to do my bit for the country, was irrelevant, because at the end of the day, one still approaches the army with the resentment and anger of someone forced into compulsory service, unsure of what the future holds, hearing horror stories from ex-soldiers of hygiene, food, corruption and battle.

And for what? It's a rhetorical question, as I know precisely what it's all about. But why me, and why now? As my friends around us become more established, pop out babies left, right and centre (though mainly centre), do we have the patience to put life on hold for all this extra time?

Gradually, I have accepted what lies before me, and perhaps some of the excitement has come back. I'm sure that I will become a stronger person through the experiences ahead, and perhaps a stronger doctor, too. Deborah will be looked after by our friends around us, and I expect that 18 months will fly by if I'm kept busy. The next time I write a blog entry, I'll be a solider.