Street Corner Medicine

My sister came to visit this weekend and when the temperature finally dropped, we took a long walk out to Ramot.  On our way back, an older woman with two rambunctious dogs stopped us.  She asked us if we were students, and I said I was.

She asked me what I studied, and I said medicine.  Her Shepherd-mix circled around me, licking my hand.  She said she had a question for me- her foot was swollen, and she didn’t think her doctor was taking good care of her.

I’m not a doctor, I told her, and I think your doctor would know more than me.

He doesn’t know anything, she said.  He’s Arab, and he trained in Romania.  And he refused to do an X-ray.

An X-ray isn’t good for diagnosing swelling, I told her.  And I’ve worked with Arab doctors and residents in the hospital, who trained in Europe, and I think they had a good education and are good doctors.

Well you’re wrong, she said.  And he said my foot isn’t infected.

I asked her if her foot was red or painful.  She said no.  I asked her if she had a fever.  She said no.

I told her again that I wasn’t a doctor, and I couldn’t examine her here on the street anyway, but it sounded to me like everything her doctor said was reasonable.

You’re wrong, she told me.  He doesn’t. He’s an Arab, and he trained in Romania.

I said I hoped she felt better soon, and wished her a good night, and walked away.

And as soon as we were out of earshot, I said to my sister, angrily, “what a racist !@#$”

“I was waiting for you to get angry at her,” my sister said.

“I don’t speak angrily to patients.” I was starting to regain my composure, and already not proud of what I’d just called her.  “I think there’s something going on with her mental health.  Like, who questions people on the street for medical advice?”

I wasn’t going to diagnose her swollen foot there on the street corner, and I’m also not going to diagnose her mental status.  But if I had to explain this interaction to one of my psychiatry professors, I would say that her judgment seemed strange.

I wish I could say that racism here was confined to the mentally ill, that it wasn’t seen in the soccer stadiums or heard from elected members of the Knesset, that it didn’t lead to physical assaults.  Hiring discrimination against Palestinian citizens of Israel is all too real.  It’s at the point where companies brag about their successful discrimination in their advertisements.

I don’t mean to paint everyone in Israel with a broad brush of racism.  One of the more optimistic things I saw this year was a massive outcry and petition drive by a kibbutz community in the north, when they heard that their beloved pediatrician Dr. Khalil would be leaving the clinic.  (It was a ridiculous kibbutz rumor, Dr. Khalil was not leaving; he was getting a well-earned promotion that would probably increase the odds of him staying at that clinic.  He was amused, but I think also somewhat touched by the whole thing.)

Last night over dinner I told my sister that I liked how medicine, how taking care of a person on an individual level, can cut across divides.  And its secret is that you are always there for the patient, that you listen to them, with compassion.  And that has to include the most difficult patients, the crazy-racist ones.  I didn’t say it was easy.

Or that it should be limited to the medical world.