The Pacemaker

 The Pacemaker

Many years ago, I started a residency in Internal Medicine in the United States. I had grown up in West Africa and gone to medical school there. I then started training in Orthopedic Surgery there but after two years I realized that this was not for me and I decided to go into Public Health.

I came to the United States to do a Masters in Public Health. While I was doing this I realized that being a practicing doctor would allow me to have more impact in Public Health, and thus I came to North Carolina to do a residency in Internal Medicine.

It did not start so well. On my first day, I met our team. My fellow intern was this tall man from the Midwest who was actually a Psychiatry resident doing his Internal Medicine rotations. We were both posted to Cardiology which was considered the toughest rotation in our program.

On our first day we met our senior resident. A smart, and handsome young man, he looked at us and said with some annoyance - I cannot believe they gave me a Psychiatry resident and a Foreign medical graduate! “They must be scraping the bottom of the barrel”! That did not make us feel good. Then we met our attending Professor R. He was an older physician who did not smile at all and appeared quite stern. We felt even worse.

That first day, I was seeing a patient who complained of some chest pain. I ordered an EKG and then rushed to join rounds. I then mentioned to Professor R about the chest pain and that I had ordered the EKG. Professor R looked at me severely and said - and you left him there? And then he rushed to the room. The EKG was just done and the patient was fine. I was however given a big lecture of never leaving a patient with chest pain alone. Needless to say, my nerves were shot.

The next day we were seeing another patient, Mr. A, who had developed a heart block. We discussed him in rounds and Professor R said that he needs a Pacemaker. I was instructed to explain this to the patient and get consent. I went to him and spent a long time explaining everything to him and asked for consent. He refused.

Now I was in turmoil as I failed even in this simple task. I went back to Professor R and told him. He was not happy. He got up and walked straight to the patient's room and asked him, why did he refuse? It was then Mr. A said he was a Palestinian from the West Bank. He said that if he had a pacemaker, he would not be able to get through the metal detectors and security manned by the Israelis.

I then saw Professor R’s face change. He looked extremely sad and much softer. I found out later that he was Jewish. He then sat on Mr. A.’s bed and started talking to him. He explained to him how important this was and he would provide all the documentation he needed to get through the checkpoints.

Mr. A agreed to the procedure and the pacemaker was implanted in him. Every day on rounds the usually reserved Professor would sit down with Mr. A. and laugh and talk with him. Mr. A made a complete recovery and was discharged with the detailed paperwork from Professor R.

The bond between a Jewish doctor and his Palestinian patient made a deep impression on me. This still gives me hope that one day our mutual humanity will be paramount and wars will be a thing of the past.