Day 3 (Day 2 was too exhausting)

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I don’t know whether to report on the work, the people, the politics, the food, the sounds, or the scenery.   Ill see what I have time for tonight.

The work is actually exhausting and difficult.  The vascular surgeon here has not a lot of modern equipment and no other colleagues so he has saved up a backload of the worst of the worst (for you Dr. Binder wherever you are).  Yesterday we did three fem-pop bypasses, today a mesenteric bypass iliac bypass on the same patient and tomorrow have 6 fistulas for access.  There is really no alcohol in Palestine, at least where we are staying, but everyone smokes, even in the hospital.  Good for business.  Marty is loving the hard work and interesting cases but dad needs some advil and a massage.  Dr. Ihab, the primary surgeon we work with is a native of Nablus and is an Arab Christian.  A very dedicated soul, very talented.  The entire staff are very appreciative and nice, communication is a problem with my 6 now words of Arabic I know, but it works.  Dr. Ihab has taken us under his wing and shown us around as well.  I could write a whole blog on him and his family(see below).

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The family photo with Dr. Ihabs family the night before at the BBQ

Besides the surgeries Dr Ihab has asks us to see many complicated patients, eg 5 different vascular malformations.

 

Enough medicine. We have toured the old city.  I mentioned in my introduction a little of the history of Nablus.  It really dates back 7-9000 years with many cities on top of cities but the known area was built by the Romans.  We walked through the Roman areas with many of the original marble and sandstone in place.

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The pictures represent an inside view of a beautiful city mosque, an early roman street, a market with the typical head covering of all the women, a 10th century tower, and of course we are eating very well.

 

A quick comment about the sounds and smells.  Spices, coffee, food, as well as tobacco smells waft everywhere.  The roosters her however cannot tell time as they crow about 2 am, and every morning at 4 am an half hour of prayers and chants blast form the loudspeakers from the mosque.  (this happens 5 times a day but I only seem to notice at 4 am).

Politics and religion dominate the conversations here and these both lead to a very sad situation for the Palestinian people, and I mean the everyday people, the families, the men and women and children who just want what we all want.  I encourage you all to read at least briefly about the history of the Palestinians, especially the most recent history since World War II.  It unfortunately is a major part of why we are here, and what we are learning about this place.  It is complicated and no end is in sight and requires more information and careful writing.  Stay tuned to this when I discuss The Case of the Missing Big Blue Suitcase.

Man I wish I could sleep like Marty.  Hes been asleep for 3 hours and this blog is his baby.

 

MWA2 out.

 

 

 

DAY ONE – THE CLINIC

DAY ONE – THE CLINIC

Traveling to the Middle East you shouldn’t expect anything to go according to plan. We needed to change our travel plans and we arrived in Israel at Midnight last night, and still needed to get to our hotel in the West Bank. Luckily there were minimal customs lines and no stops at check points.  We arrived at Al Yasmeen Hotel in Nablus, West Bank at about 2:00am local time, but didn’t fall asleep until much later because of our jet lag.

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Adorable palestine child with AV malformation.

Today was a brilliant day. Missed our 8:00am wake up, got breakfast at 9:30, and made it to the hospital by 10:00.   The Palestinian people are very accommodating, Sawsan is one of the young social workers on the team. She met us as we wandered through the hospital and directed us to Dr. Ehab. Dr. Ehab is the vascular surgeon we will be working with for the week. He sent Mark with Sawsan and Hanna to begin seeing the clinic patients. He took me and I scrubbed in the rudimentary day surgery OR. It was simple, but really not that much different from a simple surgery center OR.

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Sawsan, Dr. Ahab, and Hanna

Back in the clinic, myself and Ehab joined Mark and the rest of the team. The day was filled full of venous access fistulas, to a case of Aortal occlusive disease complicated with a retroaortic renal vein and a horseshoe kidney, to other rare disease such as Klippel-Trenaunay Syndrome.  I really cannot begin to describe what the clinic was like.  With the vast array of simple and rare vascular disease, and the intimate up front interactions with the Arab culture the day went by in a blur.

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Dr. Mark, aka Dad, looking at computer generated CT angiograms.

This city is so ancient. We spent the evening in the Bazaars and Mosques with Dr. Ehab. He grew up on one the local streets where his father owned the factory on that city block.  Ehab knew the city and the people very well. The old bazaar was a whirlwind of sights, sounds and strong odors. Coffee being ground, and quilt and comforters being stuffed and strung by hand. And we even spent time walking around the old mosque in our stockings. Everything here is completely different and new.

LONDON LAYOVER

LONDON LAYOVER

My son Martin Asplund MD and myself Mark W Asplund MD FACS are embarking on what we hope is an opportunity of a lifetime. Martin starts his surgical internship June 22 at York Hospital in York, Pa.  Mark is board certified surgeon in general and vascular surgery with fellowship training at the University of Pennsylvania in transplant. They are to fly from Central Wisconsin to Chicago to New Jersey then to Tel Aviv (Israel)….

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Our first friendly face. Ayman picked us up from the airport in Tel Aviv and drove us to our hotel in Nablus.

However it didn’t take long for Murphy’s law to rear its ugly head. We are 6 hours delayed and are going from Chicago to London Heathrow airport then to Tel Aviv. I hope this isn’t a bad omen but Marty and I a weathering it well, with a movie, glass of Spanish wine and then a nap. We will arrive in Tel Aviv at 1040 PM so I suspect get a hotel there and taxi to Nalbus, West Bank the next morningwhere we will be working at a regional surgical hospital. Nablus is an ancient city the name Nablus being Arabic derivation from the Greek Neopolis which was built on or near the same ground of the ancieny sity of Sechem 9000 years ago. It is a beautiful area situated in a valley between two mountains, Mount Gerizim and Mount Ebal. It has much history and is noted for very fine olive oil and a special soap. I hope to describe further the hospital and the region when we arrive as it premature.

….This trip is organized through the Palestinian Children’s relief Fund an American NGO centered in Kent, OH. Marty found them through a site of volunteering in the American College of Surgeons. They have been very helpful and especially our contact person Suhail Flaifl. Thank you to him. I’m sure since this is a nonprofit organization with limited funding if anyone reading this during the next 2 weeks are so moved they would gladly take donations at the PCRF website.

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Our goals in this trip is help the Palestinians with surgical care they might not be able to get, teach local physicians and trainees as much as we can, and then for us to learn the complicated relationships between politics, religions, social customs and see how these affect these conflict.  We are anxious to here from the Palestinians themselves about the controversies surrounding this volatile area. We hope to be primarily listeners

 

There will be a short day to see East Jerusalem as a tourist, or of Bethlehem.