Monday, April 27, 2009


Students season is officially open!

I've been put in charge of the medical students who are rotating through anesthesia. They arrive in three rotations of two weeks each (actually 10 working days). In this short time, we must teach them the fundamentals of anesthesia, intensive care and chronic pain treatment. It is a Sisyphean task and in essence, we are only able to give them a taste of what it means to be an anesthesiologist.

My job is to be the mother hen: Create the daily schedule which includes daily assignments to the OR, make sure that the students have scrubs, know where to go and when. Remind the lecturers when they have to give a lecture etc...

My philosophy of androgogy (adult education) is that I don't spoon feed anyone. I'm more than happy to teach, or rather guide someone who is motivated to learn. I won't force any student to learn. Of course, one must constantly find ways to be interesting and engaging. Less lecturing and a more interactive approach has served me well. The idea is to ask many questions within the background of a clinical conundrum.

I also like to correct bad habits. One of the most annoying of these is that total lack of ability to present a case in an efficient manner. Differentiating between the wheat and the chaff in the sea of information about a particular patient is one of the most difficult things to learn.

With this in mind I include case presentations as an integral part of the rotation. The students themselves choose a patient to present. Even the most seemingly banal and routine case can be fodder for an in depth discussion about developing the anesthetic plan and anticipating the possible complications.

This first group is particularly sharp. They are interested, ask good questions and seem eager to learn. It is really a joy to guide such students. After the students presented a case to the chief of the department, she called me to say that she was very impressed with this group of students. I agreed, (obviously, one must always agree with the boss) and jokingly added that they were so good because they have such a wonderful teacher. "Exactly," she said, "that's why I called, to compliment you on doing a good job with them."

Of course it always helps to impress the boss. But the truth is, that all the credit goes to the students themselves, because they have the motivation to learn. I recall the very first year that I taught. I was given three students to guide. At the end of the rotation was the obligatory oral exam. One student earned a grade of 100, the second 85 and the third 65 (passing by the skin of his nose). Assuming that I treated each equally, the only explanation for such disparate grades is the ability and drive of each one.

But hey, if the boss wants to think that I'm responsible for their stellar performance, who am I to disagree?

Friday, April 17, 2009

What do do with all that #&*%-ing leftover Matzah?

This cute video is making the rounds again this year. Michelle Citrin and William Levin come up with 21 (despite the name of the video) creative things to do with all that leftover matzah.

hat tip: The Muqata

Thursday, April 16, 2009


A couple of night ago while driving home we were caught in a fairly violent sandstorm. It reminded me of snowstorms in the US northeast of my childhood. At times we could drive only 40 kph because of the low visibility.
This is what it looks like if you are lucky enough to be flying above it (photographer - Yonatan Zur):

And this is what it looks like if your in it:

(photographer - Herb Benkel)

Very nasty it gets in your eyes, nose, mouth, ears and even hair. Yuch.

Wednesday, April 15, 2009

The Potato Festival and Other Stuff

In general, it is great to be on vacation. There are the highs and lows of course.

The 4th Annual Potato Festival was a complete bust. To make it worse, I dragged the Bogner Family (of Treppenwitz fame) to the disaster. I hope that they forgive me. The only thing that made me feel better was that there were several thousand morons just like me who also attended. The day was not a total loss as we had a tasty lunch at our favorite eatery.

Zehava and I traded family faux pas stories. (I believe we are cut of the same cloth in that respect.) Her tale had us reeling with laughter. I can only divulge that the epic will heretofore be known as: "The Great In-Law Incident of '09".

Another highlight of the vacation was the hike through Wadi Mamshit which winds just adjacent to the Nabatean ruins of the same name. Despite the seemingly harsh desert environs this was an easy hike that even our three year old managed (we kept him going during the rough bits by promising that he would scale a volcano, it worked.) Here are some pics:

There is a surprising variety of flora and fauna and this being the end of a rather short rainy season we were lucky enough to see some desert flowers. Although difficult to see, we spotted two hyraxes high up on the cliff face. Here is a pretty good video clip of a hyrax "singing":

That's me with the Aussie bush hat (Nothing beats a good wide brimmed hat). A friend and my two boys.
Taking a break.

Still a few vacation days left. Yay!

Wednesday, April 8, 2009

Passover Vacation, Yay!!!!!

Except for one on-call in the middle it is finally vactation time with the family. And the highlight will be the Potato Festival. (Would you believe this is the fourth year???!!!!)
I'm so there.

Saturday, April 4, 2009

A Cool Video

Oren Lavie, a singer/songwriter from Tel Aviv made this great video:


Hat tip: Isreality

Friday, April 3, 2009

Unexpected Praise

When I came to work in this hospital, I knew things would be different. What was unexpected, was how different, and how much I would love my work. I had forgotten that feeling. It's not about the difference in the anesthetic approach, though they do exist, they are minor differences. More like different shades of the same color.

The greatest difference is in the atmosphere. Despite an insane workload, there is very little stress. And most people are in a good mood. I can attribute this to the personality of the chief of the department. At the top of her priorities list, next to output, is keeping a happy workforce. It's obvious, isn't it, that a happy worker is a more productive worker? Does one really have to reinvent the wheel every five minutes? My previous boss, though not a bad person, is quixotic and quick to anger, accusing and criticizing in the most uncouth manner. He does this not out of malice but out of lack of style.

Never in ten years in Soroka did I hear one word of appreciation from the boss. I had excellent work relations with the nurses and the surgeons and basically everyone else who works in the hospital. Often these co-workers would express their appreciation whenever we were assigned the same cases. Patients too, would often express their thanks. There was never a kind word from the management. I suppose I got used to this. However, there were those days when I was positive that "public toilet" was tattooed to my forehead.

Now, here in TAMC (Tel Aviv Medical Center), positive feedback is almost a daily occurrence. I'm drinking it up like a thirsty man in the desert. I'm well aware that there is a danger of becoming jaded. However, I am confident that I can avoid that by simply maintaining humility.

The most flattering praise came from the Chief of the department, though, thankfully, not directly. Her secretary told me that she is very pleased with my work. The flurry of superlatives was somewhat embarrassing. But it is, an embarrassment of riches, and I will be the last to complain.

Serendipitously, I ran into one of the deputy directors of Soroka. He told that my leaving was the first signal that something was amiss. Unfortunately for Soroka, I was the first of the 10% of the anesthesiologists who have flown the coop. He admitted that at this moment he doesn't have the means to improve the salary and working conditions that exist here at TAMC, but that things will change. I told him that I didn't leave out of anger, and that if there was a serious offer I would consider returning.


Then again, I'm not so sure. The commute is a long haul. But I'm so pleased with the way things are that I don't really want to go back.
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