Rafidia Hospital

  Tuesday, day 3 of surgeries. 10 am and the team is deep into the first case, 3 month old with a tethered cord to be released.
  We start the hospital day with rounding the previous cases. Most are doing well. The most ill is Riyad who was 13 or 15 days old (conflicting information) who arrived at clinic altered level of consciousness cyanotic, bulging fontenell, heart rate of 70.
  We did an emergent VP shunt for hydrocephalus. Pt. was an IV nightmare.  Severely dehydrated.  Probably 10 IV attempts, including the one that was pulled out by mistake along with the ET tube. Oops, big feet.
Pt. Survived surgery, came to me, HR 90, cap refill 4 seconds, gave a fourth bolus an sent to NICU.
  The following am we were met by a very angry head of pediatrics. Loud yelling, short of tears i the hall. In short she was upset that they weren't notifed about such an ill baby. I have spent the last day and today doing damage control. She was right. We just don't know the system and thought protocol was being followed. The ball was dropped.
  Thankfully baby is recovering from sepsis, and dehydration he had before surgery.

Let the games begin!

We screened 50 kids today. Saw things I've never seen. One child brought in by his father with a huge hydrocephalic head, the local doctor put a 20 g angio in his head and drew out CSF and squirted into the garbage. That didn't seem so odd when I heard the dad had been doing it himself at home.

  We did 2 shunt cases. Got back to the hotel at 10.
Good night

Hotel al Yasmeen

  I arrived at the hotel yesterday at 5pm. Groggy my brain and foggy the weather. Half awake half asleep, hungry and nauseous.
  Kevin knocks on my door amd we decide to eat. Typical Palestinian meal, we have way too much food and yawn all the way through dinner. I slept fairly well, ambian is a life saver on these trips.
This morning I meet a new friend, Ansam, who lives nearby. She takes me to places in the old city I haven't seen before.
  We screened 10 kids for surgery and scheduled 5. More clinic tomorrow AM.
  I am back in my room. It is the only warm place. My heater is on so high it sounds like the ocean

Nablus, West Bank, round 3

Another February in Nablus with a pediatric neurosurgeon. Working at Rafidia hospital.

Last Day

  I am very ready to go home.  Tel Aviv is an interesting city, but with the holiday, the calm water, the hot weather, it has been harder to find things to do.
  Today the stores are open, doors rolled up, ready to go.  I have planned to meet another women pilot that belongs to the 99s.  Unfortunately this is the only day she can meet.  It takes a lot of back and forth as she has meetings and I have no phone.  Finally, Adee graciously picks me up and we drive to NE Tel Aviv for lunch near her work.  She does IT for a TV station.  The area has several tech companies and people running around with their ID badges on.  The silicon desert?
  We talk about flying in Israel and the States. She has 3 children now and hasn't flown for a few years.  
  Then I rent a bike for the long ride back to the hotel.  It is hot (have I said that?) and further than I thought.  I take my time through a large park and try to find shady streets.  It takes me just under 2 hours include the time I had to stop and dry off a bit.  My grips were slippery!
 Now I am packing and contemplating one last dip in the sea. 

What to do when there are no waves?

  The last 2 days up at 8am, I rented an SUP. The first day I went North,  the second day I went South.  Both days followed by fresh fruit juice, orange, peach, banana.  Then I hide in my room while the strongest rays are out, read a little, but mostly sleep.
  The streets are very quiet with the New Year holiday still going.  Today is the last (third) day.  So I rented a bike from the "Tel o Fun" racks that are all over the city (I have pictures in the blog from my last visit).  This trip I manage to find the instructions in English.  My Hebrew is worse than my Arabic. I rode all over for 2 hours, then returned to an open restaurant called Rothschild 12 (also the address).  They had great pastries and breakfast and great out door seating for people watching.  Menu in Hebrew only but my waitress translated for me.  For some reason I have not had coffee for 4 days.  I opted for a decaf cappuccino so I could continue my siesta program.  I will be ready for some good Stumptown when I get home.  Not that this coffee is bad. 
  There is usually a craft market tonight.  Not sure with the holiday, 3 full days, give me a break! I am off to the beach....again and will hope to find the market open tonight.  So ready to be home.

Photos of the medical center, cat guarding the medical center, Rothschild 12 and my breakfast

Buildings of Tel Aviv

  Last night I watched the sun set onthe beach near Old Jaffa.  I was distracted by the rats coming out of the rock wall, not that I don't have rats in my city, but it seems like Tel Aviv is crumbling and the rats are chewing it up.  The stucco is loosing to the elments here.  I see some rennovation, but more towers being built that look old before they are done.  Crumbly old building, old and new, odd asymmetrical tower near beach, rennovated building on the way to Neve Tsedek, typical street view and nice rennovated Bauhaus style.