Sunday January 31: My first day of work at Shaare Zedek Medical Center in Jerusalem, where the work week begins on Sunday and ends Thursday afternoon.

I depart the city of Modiin in my rented Hyundai hatchback (nice handling, weak engine) travelling on Highway 443 along the 1948-1967 border, the back road to Jerusalem through the Judean Hills. The road is an ancient east-west trade route , mentioned in the books of Joshua, Samuel and Maccabees. After just a few miles, I pass the gas station where a soldier was stabbed to death in  November. A few miles further to the turn-off for the small settlement of Beit Horon, where a 23-year-old woman was stabbed to death in January. The highway itself is safe, an observation balloon with dangling video cameras looming above.  As 443 ends, the traffic slows. The “City of Gold” is visible in the distance. The 20 mile trip takes 45 minutes

Already credentialed and possessing a temporary medical license, I am rapidly processed and issued an ID and a lab coat. The heart center occupies the entire 10th floor of the building, cardiac surgery in one wing and all cardiology services in the other wing. The echocardiography laboratory is equipped with state-of-the-art Phillips equipment, donated by the US Government.

My arrival is welcomed, because one of the 3 echocardiography attending physicians is “on-service” in the coronary care unit this month and another will be on vacation for part of the month. Within an hour of my arrival, I am performing a transesophageal echocardiogram. I am able to explain the results of the examination to the patient’s family in my halting Hebrew. The remainder of the day is spent interpreting echocardiograms, joining teaching rounds in the coronary care unit (conducted in Hebrew) and performing a stat echo in the cath lab. Later in the week, I teach the first-year cardiology fellows and observe a Mitraclip procedure (a minimally invasive feat of high-tech engineering)  in the cath lab. Kosher lunch in the employee cafeteria (chicken, Moroccan meatballs, salad bar, only one main course portion per customer, no dessert) costs 7 NIS ($1.75).

The geopolitical strife and terror are part of the everyday experience, yet are not a subject of ongoing discussion. On my second day, I was reviewing echocardiograms performed earlier in the day by one of our technicians in the ICU. On one study, the patient’s diagnosis included the familiar Hebrew word for “injury” (“peeguah”) and a second, unfamiliar word: “dihkeera”; this required Google Translate: “stabbing”. I glanced back at the patient’s name and recognized him as a victim of an attack in the northern Jerusalem neighborhood of Givat Zev. Thankfully, he is making a full recovery.

Shaare Zedek (“Gates of Righteousness”) is an inner city hospital with over 1000 beds between its two campuses. A large percentage of its patients are Arabs from all over the Jerusalem metropolitan area and beyond. On my third day, a patient was emergently transferred to the CCU from El-Mokassed Hospital in East Jerusalem. El-Mokassed is located in A-Tur, an Arab village at the top of the Mount of Olives, where, needless to say, Israelis are unwelcome. The patient presented with acute myocardial infarction on a day when their catheterization laboratory was unavailable. He was given appropriate pharmacologic  therapy prior to transfer. He was brought from East Jerusalem to our CCU by an ultra-Orthodox paramedic, then whisked to the cath lab so rapidly that the nurses knew him only as “Adon (Mr.) Mukassed.” Could an Alawite be treated in Aleppo? I doubt it.

As Friday afternoon of my first week passed, I began this journal,  inspired by the view from our 9th floor terrace in Modiin of the Judean Hills to the southeast. Shabbat was coming, a good time for all of us to pray for peace.