Saturday, May 22, 2010

where i didn't get a haircut

i don't know why, but from the minute i entered this city i felt something special about it. maybe it was the river that showed itself to me as i drove through the main street, or all the beautiful, beautiful buildings that were decorating the congested traffic. or maybe all the bicycles i saw people riding around or, maybe, maybe, the ridiculous amount of beautiful women allowed to wander the streets just like that, without realizing the safety hazard this might entail.

the city is beautiful, and the old city is gorgeous. there are many students around, and they seem to be quite happy to bath in the sun, ride their bikes and occasionally attend a class. you can rent a bike with one of those bike renting machines that are spread around the city, and you are good to go.

I wandered around and used the magical wifi and iphone to find a gorgeous hostel in a small little side street. it is a small building with colorful glass windows and greenery all over the place, and a round and narrow staircase is decorating its circumference. Breakfast is served on the roof, where you can actually see parts of the city and enjoy the sun... gorgeous!

so it was definitely one of those town you wish you can stay longer, but after a couple of nights it was time to move on to the next city, on my way to barcelona

The country of semen. No, just kidding. The country of seamen

it's kind of hard to write a post about something that happened a few months ago. I wasn't quite in the mood for writing. still aren't, probably, but here i am.

the first thing that struck me when i saw lisbon from the air is how pretty it is. i was literally excited to see green stuff, and to know that the not too far away, just a few hours, actually, is my home.

the first thing that struck me when i landed was how small and not busy the biggest airport in the country was.

Portugal is, i think, a faded version of what used to be Portugal. is small, it's old, it's old-fashioned, and there isn't much renewing about it. it can be charming, but at the same time very sad. in european standards, this country is way behind. people are catholic, conservative, and don't like strangers.

in the airport i got a little black car and started driving around. at first i checked sintra, and then decided to drive all the way to the south. check out the beaches, why not.

I reached albufera, and was excited to finally touch the Mediterranean again, but then i realized, it's actually the atlantic. portugal actually doesn't have any Mediterranean beaches, which could explain the freezing cold waters and the relatively good waves.

so i kept going to sevilla, waiting to see what i will come up with
Jose Jorge (aka JJ by his friends, which now includes myself) and his wife Marriella love Costa Rica. They were born here, in a small town an hour off of San Jose. Marilella is a redhead and everybody thinks she is a Gringa. She likes it, but not when she goes to the market. Starbucks loves this place, they get thec ir coffee there. Their best coffee, anyway. “there is elections now, and we are depressed”, he explains. We have ten candidates, but I don’t like anyone. They are all going to make a deal with America. Again”, he closes his eyes, “the president is not elected by Costa Ricans”. Apparently there is a thing called CAFTA, Central American Free Trade Agreement, and he is not very happy about it. “The first thing on the CAFTA agreement is sugar. And guess who owns the biggest sugar factory in Costa Rica”. “Your president?”. “exactly. You see, there is a lot of corruption here”. His wife is a lawyer and he works in Fedex. “it’s a very good job, I am making 600 dollars every month”. With a minimum salary of $200 (or something like that), I agree. He went on telling me about education, politics, economy, and his life. That is a very Costa Rican thing, They just don’t mind talking to you, about whatever, if you just ask. They are friendly, talkative, smiling, and polite. My impression, anyways. I probably would be too, if I lived in this little piece of heaven.
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Justine is for but can already tie his shoes. He is blonde, and his mom is a mulato. I didn’t ask any questions. He is teaching me Spanish on the way to Santa Teresa, and it’s working. “Look, I have no eyebrows”, he tells me in Spanish. I run my thumb where his eyebrows are supposed to be, thinking that they are just blonde and that’s why I cant see them. He was right, no eyebrows.
“ you are special”, I explain, and he likes my explanation. “you are special, too”, he says, with his mom and grandmother going through a long “ohhhhhhhhhhhhhhh”. He is a lucky kid. He has a mom that takes care of him, and three uncles that will kick the crap out of you if you mess with him. He is pretty bright, too. “Where is your home?”, he asks me, and I say that my home is in Israel, but I live in texas. He looks at me for a few seconds, processing the information, and the difference between “home” and “living”, and eventually smiles – “my home is in my house”. I know. I say goodbye as I get off the bus in Cobano, catching another bus. I wonder what it’s like to raise a kid in this place. I actually don’t think it’s that bad, if you have your priorities right.
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Tabacon is a freak of nature. It pours hot waters coming of of the middle of the ground, heated by a volcano, and flushing lava rocks on it’s way. The streams there can drop you on your feet if you’re not careful, which is why you have to hold on to some lava rocks as your back is washed with this marvelously warm stream of water. The place feels like a jungle, and it’s not that hard to fake, because it practically is. As you walk from stream to stream, you find yourself walking between strange trees and plants. “look!”, my friend comments on a lizard walking on the water. And it is indeed a lizard. It has a tail, a mouth, but like the lord himself, it walks on the steaming lava waters instead of around it, or in it, or something. That didn’t surprise me one bit, as this is the true land of enchantment.
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The Bus ride from Santa Teresa to Cobano is a pretty one. Costa rica’s hills and green are revealed in front of your eyes. The ocean adds its charm, and the clear sky completes the picture. The cows are mostly white, lean, and randomly herding the grass. Every now and then a sign says “se vendi”, meaning a piece of land is for sale. And who wouldn’t want to buy a little piece of heaven? (blog not continued)

Friday, February 26, 2010

Costa Rica means "Rich coast", but that is an inexaustive list of what costa rica is rich for. Other than beaches, it is rich in mountains, reefs, volcanos, green everywhere, you-name-it-we-got-it list of wildlife, happy and friendly people, and a weather that is less than 65 degrees on a bad day. It is not very rich in rich people, but that is ok. I am waiting in the bus station 50 kilometers west of San Jose, in a city called San Ramon. it is sunny and humid, and a natural breeze is cooling me off. I started working on my tan. across the street they are selling coconut juice in a small plastic bag. 50 cents will get you this delicacy . I am still amazed by the sights I saw on my way here. honestly, I didn't know green had so many shades. I saw banana trees on top of a hill next to a lake. every five minutes a stream or lake would come into view, with the hills clearing up and letting you see miles and miles away. the houses are modest and gorgeous. They are painted with lively colors of hot red, warm blue, or questionable pink. cows, horses and donkeys just hang out, lay down and munch on some grass. they really dont have to put so much effort, just chew. and they are. there are a million types of plants whose names I dont know. a bunch of trees were duped from getting sun, because they grew up in a valley. no problem. they are just growing taller and taller, now surpassing their buddies up the hill, their green leaves hanging and bathing in the sun. a guy is building his house right on a stream of water. does anyone care? there is another one just up the road, and another one after that, and another one after that. no problem. people do seem happy and content here. I cant quite blame them, as they live in heaven on earth.

Saturday, November 21, 2009

living with a mental illness is very hard. I mean, err, it must be hard, or so i've heard. or so it seems like, ahm, yeah. Not only you have to deal with your own limitations and concerns, you also have to deal with people's reaction to you. and then, if you are obsessively concerned with aliens, think you are about to discover the secret of life, or just keep hearing bob dylan talking to you, you can't quite take care of you health issues, right?
so you don't brush your teeth as vigorously as you used to, and shower becomes an option. and then you might skip a meal or two, and sometimes sleep on the street. and then street actually becomes your home, so you shower even less, and you sleep on benches, which can't be good for your back, and some teenage punk kids might decide to torment you a little, just for fun, since it goes well with alcohol, and you might end up in the ED.
Or, it might just get cold outside. and you don't have a home. and we have blankets.

We are not quite sure where Mr F fits in that list, but we suspect it is all of the above. Regardless of cause, and despite the fact that Mr. F has not voiced any particular affinity to Bob Dylan, he walks through our door on winter nights and complaining he can't swallow his own saliva.
Now, this is an important point, because it is not that Mr. F can't swallow anything, like food, beer, insects or feces - he is handling these quite fine, but it's his own saliva that he just can't swallow.

He is a tall and thready gentleman, with extremely bad dentition. he wears the same clothes, usually, and somehow he always seems to end up in hallway bed number 1.
If you ask Mr F, he will tell you that he is perfectly normal, and does not quite understand what people want from him. he just can't swallow his own saliva, no matters what his voices are telling him. He is a very calm and gentle man. he waits in his bed patiently until a doctor sees him, he patiently (and repeatedly) would tell the poor-new-intern-that-doesn't-know-him-yet the story of his life, and of his saliva, and then, lsiten carefully as the doctor tells him that he is alright and that he can go home. he nods, understanding, and comes back the next day.

My colleagues would probably kick me in the head for this, but in a way i hope Mr. F will keep coming back during those winter nights so we can check his swallowing problem. I am not quite sure where he sleeps at night, and at least that way we know he is safe.
It's not easy being a schizophrenic these days

Friday, October 23, 2009

Patient number a-15902 is lying in bed 10 and thinking about death. There is not much news in that, she has been thinking about death for the last 6 months, but for some reason, death doesn't seem to be thinking about her. sometimes it seems like it is finally coming, but then, like a bad dream, she is consciouss again, feeling everything and thinking about everything. I am dying to ask her what she is thinking about all this time. we are used to her being invisible. she is very quiet, as intubated patients tend to be, and usually they are also totally out. she isn't, however. she can hear everything. that is about the only sense she has left, along with the hopefully-worn-down-by-now sense of pain. today is a big day for her. we cut a hole in her throat and put the tube there, instead of going through her mouth. we really, really didn't want to do that. we even managed to extubate her a couple of times. but she just couldn't breath properly, and had to get on the tube again. and now there's a hole in her throat.
"water", she moves her lips quietly, unable to make a sounds, and i really, truly feel that I want to die. "just a minute mrs. K", and I soak a gauze-on-a-stick with water and let her suck on it like a popsicle. that is only one of the bonuses of removing the tube from your mouth and placing it right through your throat - you can start tasting things again. she is nearly ripping the gauze off in thirst. She definitely wants more. I am looking at her tatooed patient number, a-15902, and wondering if she ever experienced thirst like this over there. I want to ask her about that as well, but she wouldn't be able to answer. I would give her a pen and paper to write on, but she is totally blind. well, at least in europe she had her vision. at least that.
she gulps half a glass of water using the gauze-on-a-stick technique, and I am getting a little worried. I don't want her to aspirate anything in her lungs. for the last 6 months she has been poked twice daily, at least, using ugly needles, and sometimes tired physicians. she then had half her bowel removed due to an infection (caused by antibiotics we gave her, by the way). she then went on and off the tube a couple of times, each time getting it back, each time emergently, without being too cautious about lacerating her lip, or breaking her tooth. then, just as a cherry on top, she got a hole in her throat. It would have been great if her husband could at least come and support her, as he had for the last 30 years, being her cane and her eyes, but he is dead now. he died in the same car accident that kept her alive, conciouss, aware and remembering. She never had children, and the only family member sniffing around keeps asking us if we think she is going to survive because he needs to take of her finances. Why don't he gauze-on-a-stick a little, instead?
I am thinking about Job right now, and his dedication to god, and the torments he went through, and I have a feeling he would long be pagan if he had to go through what patient a-15902 went through. they say women are tougher than men, but this is just too much. If Satan was a doctor (not a very far fetched theory), this is probably what hell would be like.
We do try to treat her pain, really, realizing it's here to stay for a while, but then we might not be giving her enough, and it's not like she is saying anything, or protesting against the damn needle down her artery. on some days she is too feeble to resist, and in others, you have to hold her hand so it wouldn't withdraw once you poke her. I am actually doing it right now, and her tatooed number is looking right at me. I am going for her artery, right between the '1' and the '5', and I am wondering what was it like when they tatooed that number on her. did she resist? was she too feeble? she had her eyes back then, does she remember the tatooer? does she remember me?
She takes advantage of the nurse not noticing her for a minute, and tries to make a run for it by pulling the tube from her throat. the machine starts beeping. "stop it!" shouts the nurse, a very patient one on most days. I think he was concerned about her hurting herself more than anything else. he ties her hands and puts everything back into place. I go up there and her eyes are red and tearing. The lady means business. she does, indeed, want to die. the sooner the better, and everyone seems to have the same sentiment. why is she still with us then? we had younger patients, healthier patients, anything patients, who passed away. So why her?
I think about Mrs. K every day after work, and before I go to sleep. It seems like the ICU keeps reaching new peaks of human suffering, or maybe it's just the same peak all over again, what do I know.
I only know that I am not sure what force of life keeps Mrs. K going. I don't know if this is a story about the human spirit or just human misery, about indifferent doctors or about the futility of medical treatment. in fact, there may be no lessons to be learned from this, but just to tell its tale, and let you know, that there are people out there like Mrs. K.

Friday, October 2, 2009

Home

i am driving through heavy traffic on my way to work. the woman next to me slows down further, brings down her window and shouts across the road: "sarah!"
a woman across the road slows down her car, opens a window and says "Hi! how are you?"
"Good, and you? Have you heard about Esther?", she puts on a sad face.
"Yes, I went to the funeral", the other woman has a sad look as well.
"Ok, see you later!", they both smile and drive away.

To me, this little encounter is incredibly Israeli. First, they slow down traffic for a quick hello. second, within a second they go on to talk about death, and then it's all good again, and then they drive off.

that's how, on my first day in Israel, I knew I am home again.