The song is “25 or 6 to 4″ by Chicago.  The song is, according to a web search, about staying up all night trying to finish writing a song.  So appropriate!  A song about writer’s block!

Waiting for the break of day,  Looking for something to say

Flashing lights against the sky, Looking up I close my eyes

Sitting cross legged on the floor, Twenty-five or six to four

“Just go and lay down and I’ll call you when they bring him out of surgery. There’s no point of both of us losing sleep.”

Naomi decides he’s right.  So she goes toward the elevator, pushes the button, and looks over her shoulder but her husband is already walking away to the OR waiting room.

He’s right, she thinks.

It’s 3:20 AM at the Ashkelon City Hospital. It’s Passover week, and we should be on vacation.  We should be asleep, resting up for another day trip with the children in the morning. Instead, we’re at the hospital waiting for our four year old son to have surgery for a twisted bowel. Naomi feels like shit. She feels like it’s all her fault.  She should have taken him to the ER sooner.  But past experiences with the snarling, endless red tape of the Israeli health care system put her off going straight there.  Better to have a referral from a doctor than just show up with a stomach ache, cramps and vomiting at the ER.  Because past experience says it’s just a 24 hour bug or he ate too  much matza and it’ll pass.  It didn’t pass.  And because it’s Passover, the clinics are only open half days until 1 PM.  So when her husband finally gets back to his parents house where they are staying with the other four children for lunch, there isn’t any where to take their son.  They can’t get a doctor on the phone to find out what to do.  The national switchboard for their HMO isn’t working after 1 PM either.

Yet the feeling that this stomach ache will go away persists;  Naomi is sure that he’ll sleep and wake up hungry and everything will get back to normal.  When he wakes up, he’s still moaning and he throws up whatever he drinks.  It’s now seven hours since he first complained of stomach pain and vomited.  It looks like something is wrong, something that is not a virus or too much matza.  There isn’t anyone or any place to turn to for medical advice.  That leaves going to the ER, and all of Naomi’s years of working in hospitals and clinics tells her to stay away from that place with a young child until the last resort.  Only in a no other options, middle of nowhere situation do you go to the ER for with a “routine” problem.  Stomach pain, vomiting, no fever, they would end up sitting in the waiting room with really sick people, all those people who are too poor, too dumb or too stubborn to go to a doctor early for treatment. They have let whatever they have get out of hand.  Why should she let them be exposed to all that disease unnecessarily?

Seeing this problem wouldn’t resolve itself on its own, at 4 PM Naomi’s father-in-law takes her and the boy to the nearby town of Kiryat Melachi to the Magen David Adom (MDA) station to be checked by the after hours  doctor on call. (Israeli’s Red Cross Service)  There is no doctor there yet, only from 7PM.  You can go to the ER, if you want, ma’am.  The kid is weak, in pain but ambulatory.  It’s your call, ma’am. We can’t give you any referral papers or medical advice.  We’re not doctors; we’re EMT’s.

“Ma’am” decides to wait for the doctor.  So they go back to the house and wait until 7PM.

This time Naomi and her husband take their son in to MDA.  The doctor on duty is every parent’s worst nightmare:  He’s Russian, he barely speaks Hebrew and no English, and he reeks of alcohol-don’t light a match near the guy-he’ll explode.  He needs a shower. How its possible to smell him over the booze is beyond belief. His lab coat is gray and his shoes look like he shuffled through a trash heap on the way to work.  Even his glasses are grimy.  She doesn’t want this drunk crude ball to come near her son.  She screams inside her head: G-d in Heaven! I’ve waited ten and half hours to have him examined by a doctor and this the doctor you send me?!

Amazingly the doctor handles the boy with a sureness and thoroughly checks him starting at the top- head, neck, ears-nose-throat, glands, armpits. He listens to his heart and lungs and gently lays him down and presses on his belly.  He says he has twisted bowel and it’s completely blocked.  He presses again, he says, here and here.  About half the size of his fist, he shows them where on the left side.  He needs surgery.  How long has he been like this?  Eleven hours? He walks off to the desk and starts to fill out a form.  His Hebrew writing is slow.  He laboriously coaxes it from the end of his pen.  The form takes longer to fill out than the physical examination.  They wait for him to sign and stamp it.  He asks for 120 shekels in payment. Naomi’s husband picks up the boy while Naomi pays him, digging around in her wallet and purse for the exact amount because they don’t have change. She up gives, writing him a check, despite him telling her he won’t take it, only cash, but given the circumstances, he takes it in the end.  It’s that or nothing.

By 8PM they are at the grungy Pediatric ER in Ashkelon, which surprises Naomi. She didn’t think they had a separate admissions for children.  In Israel, things vacillate between state of the art and Middle Ages.  You could buy your groceries which were scanned with a credit card in 1979 but you still can’t return anything and get your cash back or a credit on your card, even if you have the receipts, even if you just bought it ten minutes age and  haven’t left the store!  So separate admissions is already a hopeful sign. Naomi is still tense that the doctor will be like the one at MDA and she won’t be able to communicate with him.  The other down side of Israel:  if it’s not in Tel Aviv or Jerusalem, it’s not worth anything.  Israel in 1996 is till like a third world country.  Everything spins around the axis of the largest cities, especially around Tel Aviv where over one third of the country lives.  And in the spin, all the dross is thrown out to the margins.  Ashkelon is the last city before you reach the Gaza Strip and the 4th world.  G-d help my baby, prays Naomi.

The admissions clerk see the diagnosis and brings them immediately into an exam room and calls the nurse to come do the uptake. The ER doctor is nice.  He’s Israeli but he’s different and Naomi can’t put her finger on what it is.  Finally he’s outed.  He answers the phone and starts to speak in Arabic.  Okay, so he’s an Arab. Lots of hospital  ER staff are bilingual in Israel, she tell her irrational side.  You only want some one from South Africa, like your family doctor??

He does his own exam and agrees with the drunk MDA doctor- the boy’s intestine is blocked. He smiles at Naomi:  It’ll be okay. He’ll have to have surgery.  You got him here in time.

“You got him here in time.”

Naomi is standing in the elevator, trying to remember which floor the Peds department is on.  There is supposed to be a place for parents to sleep up there.  The Hebrew letters swim in front of her eyes and the few English words are not helping her find what she wants.  Some one has translated Pediatrics “Children’s” and it wasn’t registering in her guilt ridden, exhausted mind.  She pushes ’3′ and the elevator lurches up.  The night nurses are in their office behind the counter and don’t even look up.  She wonders if they will even know that she is here or who she is, or why she’s here.  There is an room with cribs and futons, but empty of patients on the left side of the hall.  She takes one off the top and it unfolds before she has it on the ground so she kicks at it to get it straight, pissed at the stupid thing, wanting something to easily or smoothly for once today.  She plops down on the thin foam.  There is no sheet, no pillow, no blanket and no one to ask because in all likely hood if they knew she was here, they’d just send her away.  So she lays down on the futon that smell of musty old feet and dust and foam rubber.  She takes off her glasses, puts them in her purse and then hugs the purse to her chest.  She lays there wondering how she will sleep, feeling guilty about waiting all day to bring him to the hospital, praying that her son will be alright.

“get up. You are not allowed to sleep in here.”

Some is kicking the futon.

I can’t believe this, Naomi thinks. There is sunlight, and a nurse, probably the head nurse from the day shift considering her tone and attitude, is standing over her with a clipboard in her hand.

“Put the futon away, and get off this department right now.”

Naomi is up and obeys.  It’s 6:10 AM.  The sun is shinning through the windows high up in the room.  She arranges her clothes and starts out for the elevator.

She finds her husband near the surgical recovery.  He looks gray and has heavy stubble  He looks a mess.

“He’s out? Is he okay?”

“He’s out. He’s okay now.  For the time being.”

“What’s that mean? Wasn’t the surgery successful? What happened?”

“The surgery went fine.  He’s had a bad reaction to the anesthesia He stopped breathing more than once. His heart stopped.”

“Oh, my G-d, no-”

“He’s stable now.”

“do you want me to-”  she reached out to touch his arm but he brushed her off.

“No. I don’t want you to do anything for me.  I’m going back to my parents’ house.  I’ll be back around 2PM.

He walked past her towards the elevators

Her son, her husband. Her marriage.

My whole life is on the critical list, she thinks as she watches her husband disappear into the elevator.

© Michal Nancy Karni 2012