Ishe Ishe: ode to my Ethiopian patient

By now, I have given up remembering the new patient’s name from Gaza. Or maybe, without even trying, I remember the name: Atallah. Is it a curse to remember names, faces, and above all stories? I am not sure.

A 7 month old child transferred from Gaza after convulsions was the brief description given to me, while I was in the ICU about to begin interviewing my Ethiopian patient’s mother. I was asked to translate for the father, Mohammad, who did not speak Hebrew. I looked from far at the child laying in bed, unable to examine him or take a look at his folder only provide the immediate assistance of translation.

The child and father needed to be transported to another hospital to provide care for the child. The ambulance was going to leave from Barzilai hospital, instead of waiting for the ambulance from Gaza to arrive to Barzili. I accompanied Mohammad, the father, as we obtained his ID papers. He had to deposit them at the reception before entering the hospital.

On the way to the reception, he told me his story. He is 28 year old married to a 20 year old, with their first child being Atallah. Before knowing that she was pregnant, the mother had undergone some sort of imaging study after abdominal pain, underwent surgery where they found a “bag of water”, a “pregnancy out of the uterus” and then told the father, “Congratulations, you are expecting a child!” The parents are first cousins. The child is the product of full term delivery. The child was born vaginally but was told that he “drank the water in the uterus”.

He went home and a few days later, he turned blue and could not breathe. The parents took him back to the hospital and was hospitalized for two months. Since then, he has been home, not feeding well and had many seizures. The father was told at the hospital in Gaza that there was nothing more they could do for Attallah. He applied for a permit to come to Israel two months ago and only obtained it a few days ago.

For some reason, whoever gives permits to patients from Gaza brings them first to Barzilai where not much could be done to complicated cases and then the patient is transferred to another hospital. Sometimes, this process wastes valuable time, as is the case with one six year old who came from Gaza with neuroblastoma. By the time she was transferred to Dana hospital, three weeks had passed since her departure from Gaza. The girl’s name was Shireen. Occasionally, I wonder about what happened to her as I realized that she perhaps had a stage four neuroblastoma.

“It was easy to get from Gaza to here,” Mohammad told me. And I wanted to ask him more questions, “Really? But on the news, things look really bad. How did you manage to come? Tell me more about life in Gaza, about your life. Here, I will buy you tea, and we will sit and chat.” But, the guard came and gave him his green ID papers, and with that I accompanied him back to the ICU where the ambulance driver, a doctor and a nurse were going to accompany him to Ichilov. Yet again, another patient from Gaza that I will not see again, I thought.

As I walked back into the ICU, I remembered that my patient of the day was an Ethiopian having presented with acute gastroenteroritis, and with maple syrup disease in the background. His 50 year old mother was sitting next to her, and so was the aunt. The mother had her head covered with a scarf with the colors of dark yellow and read. She also wore a dress that had a thick fabric, with dark colors of red and yellow. And behind the mother, in the sink, there was a pot of tea, golden. A clown was standing next to the crying child, trying to play a game with him.

I, the medical student with my white coat and stethscope walked into that small space of Ethiopia. Having realized as I began to interview the mother, that next to her lied another little space of Gaza, with the father, Mohammad, standing next to his son’s bed, ready to leave.

The intial interview began with the distance that I, as a medical student, have noticed I learned to have. From across the bed of a patient, I usually interview a patient or a mother. With Israeli patients, the distance is usually well appreciated and I am able to get answers to my questions. Not with the Ethiopian mother.

Conducting the medical interview has been quiet hard for me, as my medical education gives me all of those tools that I always feel are too strict, that don’t give me space for creativity. Seeing the pot of tea at the sink, the aunt sitting across from the mother, I knew that I could claim a chair all too familiar for me to obtain the patient's story- the chair of humanity, and not that of distance and professionalism with a list of questions to ask.

Parallels of being Palestinian and what I had always wished that someone would say when communicating with me went through my mind as I wondered how I could obtain the information I needed from the mother. I did not speak Amherek, neither did I understand the Ethiopian culture. Story telling is part of most cultures, cultures that are not western. “Tell me, about his birth, your pregnancy,” I said.

The mother’s story began to flow, interspersed with her suffering while caring for her child. I knew that even though we both spoke Hebrew, we did not really understand each other. Some questions I asked, she would say yes, even though I knew that the answer would be different. A lecturer once told me that in Ethiopian culture, the speaker gives options for the answers to obtain an answer, especially if the speaker is in a position of authority, such as a medical personnel. I gave more option in my questions and the mother’s patient seemed to give other more expected answers of his case.

“Ishe, ishe,” I said, agreeing with what she said. And the ice broke between us! I made it into that little space of Ethiopia, after having been in that little space of Gaza a few minutes ago in the ICU. There is still much that I am sure that I have missed in my interview, and yet, herein lies the art- the art that enchanted me to study medicine: story telling, story interpreting, story collection.