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Joe's Trial  

 

 

The rocky hills of the Israel/Lebanon border were alive with war in 1985. A long protracted war, where the IDF attempted to create a safe-zone in southern lebanon as a bulwark against Shiite Hizzballah and other Muslim factions terrorising Israel. 

The cancer ward of the Children's Hospital of Wisconsin was alive with activity in the winter of 2000. The unending war of the doctors and nurses against their mortal deadly enemy was waged in the wards and the clinics, the laboratories and homes of the afflicted. 

Those seemingly far worlds are brough together, with a bang,  in the life of Joe Bergman, afflicted by both war and cancer which seem to kill everyone he loves.  The only way out is to risk his life yet again, to confront the most diabolical plot to bring the horrors of disease on the Children of Israel. 

 

Tavassim

 

They called it "Tavas" and it was the most curious army code- name for a combat activity since it was a truism and an oxymoron all at the same time. "Tavas" was the army parlance for a small armed infantry patrol of the hostile country-side.

 

Sometime during the Israeli invasion of Sothern Lebanon it became obvious that the usual armored patrols were both useless and essentially deathtraps. 

The APC  M-113, nicknamed Zelda, is an armored box that rolls on tracks with the main offensive weapon being the 0.5 inch heavy machine gun mounted on top. Combat personnel enter the vehicle via the posterior ramp which lowers flat for embarkation and is mechanically raised to close the box. It is a highly maneuverable in all terrains and is very adept in muddy conditions. The armor is aluminum so as to save weight and the engine is in front. The floor is lined with sand-bags (thereby obliterating any weight savings thought up by the designers, but useful to minimize land-mine damage). The real firepower of the vehicle is in the hands of the four to six soldiers whose torso, shoulder and helmet-clad heads and personal weapons protrude through the top. When the Zelda is in full charge, tracks churning, Galil assault rifles firing in bursts, and the 0.5  bucking away, it is an awe-inspiring, fearful fighting machine. When the same machine is stuck in a narrow, muddy, Lebanese alley, see-sawing back and forth trying to turn a corner, it becomes a death-trap for the crew, exposed  to any wel-placed sniper or even an RPG-7 in the hands of ill-trained youth. After taking a number of hideous casualties, the Israeli command came up with Tavasim. Small contingents of 5-6 soldiers would exit the strongholds at random intervals and scour the countryside and villages and towns of southern Lebanon. They would look for terrorist activity, search houses designated by Shabac, and ferret out "initiation points" where explosive devices were waiting for the unsuspecting patrol or transport, or water-wagon. They would walk on foot and control the land through stealth and surprise. That was the theory.

 

 

“Tavas" translates as peacock, and the peacock is the most conspicuous of birds. Tavas was supposed to be secretive and blend with the land. That was the oxymoron, since the Lebanese girls watching the stronghold always knew when a Tavas went out. Tavas activity always included a patrol through a designated village, to show the Flag, as it were. That is when it was a peacock.

There was one aspect of military activity that the  Israeli Defense planners did not take into account. The Israeli troops were trained on the concept of the "Purity of the Arms" which meant that civilians, women, and children, were not to be harmed. The guerrillas had no such inhibitions and consequently the Israeli army was at a severe disadvantage.  Children, schools, and Mosques were the cover behind which the guerrillas initiated  their attacks. Their fear of the armed Tavassim diminished when it became  obvious that they never shot at random, and were not a system of terrorism as were the Phallanga or rival Palestinian groups.

Yossi Bergman had changed his colors a few days before. The bus from Tel Aviv discharged a wide-shouldered young man, a typical student, shorts, sandals, and a blue teeshirt,  carrying  a small ruck-sack, into the melee of the Safed bus station. A group of individuals, each different but all joshing and back-clapping, in their middle twenties  to early  thirties, came together. The military truck, a D-500, motor badly abused by the corporal driving it, halted at the curb and the group climbed into the back with the usual bantering about the lousy army trucks. After 30 minutes of rough riding through the hills of the Galilee, the truck entered a military installation, home base for the 801 Battalion. By this time the civilians adjusted their mind-set, they knew who had a new baby, who started a new business, who got canned  out of work and who did not show up for Milu'im, the reserve duty most Israeli men endure year after year after year till they are either too old or too infirm for duty. The 801 battalion was an infantry unit, made of men in their prime, the back-bone of the Israel Defense Force, the likes of which bore the brunt of the failed occupation of South Lebanon. They spoke a multitude of languages, Hebrew and English and Russian and French. The group dismounted from the truck and immediately became a Platoon.


The Advance  Detachment had arrived a day before and completed the setting up of the changeover from a bunch of students, clerks, utility linesmen etc.. into a fighting unit. The men got their KitBags with clothes that did not fit but were clean and immediately set about trading them for size and fit. Webbing, and helmets and coats came out for inspection. Then they lined up for their personal weapons, which were the Galil assault rifle, a hybrid between the American M-16 and the Russian Kalachnikov. Each man checked his weapon’s serial number against the list and for the rest of the Milu'im would be inseparable from his baby. The minority signed for the MAG machine gun, a 12 kg pain in the neck that was designed to provide continuous covering fire for the assault troops. The MAG artists would specialize in extracting single shots, shooting from the hip, from a machine set up to fire 600 rounds a minute. They all received their complement of  7 magazines and sat down to the task of cleaning the oily magazines and filling them with 35  rounds each of ammunition. The officers started moving about solving the inevitable problems (hey, this webbing is lousy, where are the good ones?) and assumed the care of their soldiers. The cooks came up with some coffee, the thick ,black stuff in even blacker cans, veterans of many Milu'im. Lieutenant Yossi Bergman, now clad in olive-green fatigues with epaulets and army boots and the Galil swinging from his shoulder went off to find Headquarters for the Officer’s meeting. He settled with the rest of the officers in the group that was essentially his Company on the rough benches painted inevitably in drab green.

What followed was the same old Routine. The Lieutenant Colonel came up to the podium and faced his officers. Matti Cohen was 42 year old and he had seen his share of wars and campaigns. This was going to be an onerous one because anybody not blinded by the Glory of Power could see that this Lebanon thing was one big bloody fiasco. He knew that this army was based on quick action by men of tremendous potential. This was an army that made the old BlitzKrieg a slow-motion affair. It was not an army that could occupy territory  by instituting a state of Nazi-type terrorism. The truth always came out in the end but now the job at hand was to finish this Milu'im without any casualties. Lieutenant-Colonel Cohen stretched his pointer and slapped it hard on the 1:20,000 scale map spread behind him.

"Pipe down guys.  This is Nabatiyeh and we are going to take it over from the 709 Battalion TONIGHT" Everybody craned their necks and started evaluating the Ground. "Yoram Klein , our new Intelligence officer, will give you the Land and the Forces and so on, so Pay Attention."

And so it went for the next two hours. The land, and the opposition, and the Friendlies and the Hostiles, and the Strategic Points, and location of strongholds, and Vulnerable spots, and communications, and Assignments. The men jotted down furiously in their little Koh-I-Noor spiral notebooks  and soon it was lunch time and Army Rations and eating straight from the can. Finally the officers dispersed each to their Platoon to brief them about the coming 26 days.

 

 

All this was already a few days ago. The 709 Battalion people had whooped with joy as soon as the trucks rolled into the strong-holds which were really a house or two surrounded with dirt perimeter walls piled up  by the D-9 bulldozer. They wasted no time at all in signing the APCs and the Jeeps and Command Cars and everything Military to the newcomers, and in the meantime passed along the information critical to survival in this hostile place. "Don’t go into that corner shop, even though the VCR's there are dirt-cheap, one of our guys was knifed there pretty bad, but they didn’t allow us to demolish the damned place, I guess they want us to use Harsh Words" and "When you turn the corner near the Nabatiyeh cemetery, right in the center of town, watch the fence carefully because they like to throw a grenade at the Jeep, and then run through the graveyard to the Souk and disappear into the alleys. We call that turn Grenade Alley" Then they climbed into the trucks, rolled the tarps up all the way, and the hell with the wind, and pointed their guns at the perimeter. If anyone would even spit suspiciously they would open 360 degree fire, they were not going to die on the way Home.

Lieutenant Yossi checked his webbing, checked the water-bottles, grenades, checked his topographic map, flashlight, night-sight,  placed his Gallil across his torso, jumped up and down to hear if anything was clicking and strode out of the bare dark room to inspect his troops for Tavas activity.


They were all ready for him, standing in a loose line, each checking his buddy's load. First he checked their weapons using a flashlight to see that chambers were empty. Then a brief explanation of the assignment,  the order of movement. and Open Fire orders. They checked communications ("Yonah1 from Red Tavas how do you receive? Loud and clear you finally changed the batteries" "Go to sleep couch-potato, Red Tavas over and out"). Each of the soldiers had his special load in addition to his personal firearm. Jonathan was the Medic and carried the medical bag. Eitan was Radio, and Kadosh was Grenades. Ami carried the Russian RPG-7 anti-armor rocket launcher found in such quantities in the armories of the retreating Syrian army that there was enough to supply the whole Israeli army. Shmuel (Sam to his friends) carried extra magazines, all packed with ammunition for the Gallil. Satisfied, Yossi headed for the east perimeter and waited 15 minutes quietly to let his eyes adjust to the dark. It was three o’clock in the morning and they were a pre-dawn Tavas. Yossi said "Everybody, load and cock and put the safety on." The magazines were rammed in with a slap and the guns were chambered and they all felt for their safeties just to make sure. No one laughed or joked, this was the real thing.

They climbed away from the Company headquarters though the cherry trees and crossed terrace after terrace. This was a bountiful land if it were left alone and not used as a terrorist base, Yossi mused. In fact the cherries of Lebanon were famous in the Middle East. He was Point, as is the custom in the Israeli Army. Tradition dictated that the order to charge was not "CHARGE" as in other armies but FOLLOW ME. This was one of the strengths of this army because personal example was the rule. It was also the weakness of the army because the junior officer cadre was decimated in a real shooting war, up to thirty percent of the casualties in the Yom Kippur war were junior officers. As they neared the houses at the top of the hill, the dogs began barking furiously and they skirted the motley hamlet. Yossi did not consult his map at all. He knew his route by heart. During officer training it was not unusual to be required to learn a 20 mile route based on the topographic map and air-photos down to the last hill, and valley, water-hole and wadi. His night vision became more and more acute and soon he felt as if he was walking in bright moon-light. It is remarkable how much ambient light is present at night.

Light was beginning to show up in the east, which made the immediate countryside darker by comparison. Yossi led the Tavas via a circuitous route to the main road, which was really a narrow ribbon of asphalt winding through the hills, following the natural terrain, as much as the old donkey route did before it was given that thin coat of asphalt. He figured that this particular spot was a great place to ambush the incoming transports, and that was his function, to prevent such road-side explosive ambushes. The Opposition had a tactic where they would fill a jerry-can with gasoline, attach a TNT block and imbed a primer explosive into the block. Then they would swaddle the whole thing in burlap with construction nails and hide it road-side where the road was cut into the hill so that the overhang would deflect the blast to the vehicle being ambushed. Then they stretched an electric cord twenty or thirty meters away and above the level of the road, up sun if possible. The initiation point was really a car battery hidden behind a large boulder, where the Fatah, or Amal, or Islamic Jihad, or any of the other splinter groups would place a 17-18 year old with a promise to be a Shahid (martyr) if he happened to die, to initiate the blast. In six Tavasim so far Joe did not find the expected ambush and he dearly hoped that he would not find one for the rest of his tour of duty. The Tavas spread its tail quietly and the men started moving in a wide fan, scouring the terrain.

 Right where it was expected, the middle man in the 6 person contingent stubbed his toe against the truck battery. He stifled his curse and instead crouched.  Then they all crouched. Yossi went down on his hands and knees and scooted between the boulders to Ami who had found the Point.

This was a big battery. His hands traced the wires that were hidden in the underbrush and suddenly he turned cold, the sweat that was building in his sodden shirt turning to ice in the dawn cold wind. This meant a firefight, this meant that his crew may be hit and someone may be wounded or die. On the other hand, doing nothing may spell death to the transports bringing food and water and troops.

He quietly told the others to get into an ambush configuration and followed the wires to the road below. It was lucky they ran into the battery because these wires were well hidden. The charge itself was concealed behind a roadside bush below an overhang. This was the proverbial death-trap. Yossi crawled back up the slope and joined his Tavas. They had the Galil bipod out - that would give them better stability for long bursts. The RPG-7 was loaded and ready. The heavy loads were off their backs and they were ready to assault. Yossi pressed the phone to his ear.

"Yonah 1 from Red Tavas do you read" he whispered.

"This is Yonah1, what’s up?"

"We found an Initiation Point on hill number 225, ambush is set, radio silence from now on."

"Roger that Red Tavas, giv'em Hell."

Joe knew that the whole section will now come alive, Company roused, Battalion alerted, Division notified. But tradition dictated that he was on the Ground, he was in charge, and additional forces would come in only if he called for them. Otherwise this was his show. All this has happened a hundred times before, mostly the would-be bombers would not show up and the Engineers would be called to dismantle the charge. Joe settled down to wait and see if his quarry would show up. The wind blew colder and he shivered. His thoughts wondered to his cozy apartment in Tel-Aviv, 100 yards away from the warm Mediterranean, medical books, magazines, papers strewn around, and the occasional girl trying her luck in taking Yossi away from Singlehood. Jewish mothers taught their daughters that they aught to marry a Doctor, and some girls were persistent.  The men all cocooned in their thoughts and remained alert because the light was coming on fast.

 

They were four men and they were heavily loaded. One carried an RPD  0.3 inch machine-gun, another, two boxes of ammunition, one had a Kalachnikov and a backpack full of, probably, grenades. The fourth who kept looking around was the leader. They all wore the  uniform  thick Islamic-mandated beard, black-and-white checkered Keffieh wrapped around  the  head and neck, and   multi-patch jungle  commando fatigues. They were young, devout, and they were going to kill lots of Israelis today. Their watchers on the border had called on the phone (The stoopid Israelis never destroyed the Nabatiyeh telephone exchange) to say  that a convoy was heading in the Nabatiyeh direction and no one had seen any patrols nearby. They had had their Blessings bestowed by the Kadi who promised them that if they are killed in battle then they would each become a Shahid and as such would go directly to Heaven filled with beautiful large-breasted women and food and drink no end. They were spiritually ready to fight and die if needed. Lieutenant Yossi watched  them  in between a boulder and a bush and agonized  how to spread his fire-power best and avoid casualties. He felt the crushing burden of responsibility towards his boys' mothers, wives, girlfriends, to bring them back safely. The anticipation built up inexorably and he waited for the sun to come up behind him and blind his quarry, just like they had planned in setting up the ambush. This was what he had been trained for. His Tavas had practiced this scenario before and each knew his part. The first rays of the sun shone through the haze, the sounds of heavy diesel motors crept up from the distance, silencing the chirping of the early morning birds and it was time to strike.

 

Yossi snicked the safety off, touched his chin to check for the helmet strap and raised his Galil to eye level then raised himself silently above the boulder. His soldiers, students, shopkeepers, taxi-drivers, followed suit. He aimed at the Guerrilla leader who at that very moment swiveled around and looked him straight in the eye through the slit in his kaffieh. The warning cry  died in the short burst and the shells spewed from the Galil. The young man appeared to be picked up and slammed  back against the boulders behind. He did not fire a shot. The Gallils around him joined the fire and the  ricochets were whizzing into the stones and the earth and the people. The other three guerrillas were better hidden and disappeared from view immediately.  Suddenly a single Kalachnikov, a different cadence and tune opened up, wildly inaccurate. Yossi stopped his fire and screamed, "Kadosh, shnei rimmonim (two grenades)." Kadosh, the small sun-burnt Yemenite was ready. He twisted the ring, pulled the pin, released the boom and counted 21,22 and threw the grenade like a pitcher. They all hit the deck. The explosion threw dirt and as it did another grenade went  the same way. Joe raised his head slowly and a burst of fire exploded just to his right. There was no alternative but to assault. Kadosh and Jonathan both had grenades ready and he signaled them to throw. Yossi changed his magazine, slapped it in, and cocked his weapon.

The four explosions were close together. The damage to the enemy unknown. His heart was in his mouth and the taste of fear was metallic. Yossi jumped to his feet suddenly weightless. His boots were winged. He screamed "AHARAI (follow me)" and started running, his Gallil coming up to his shoulder and his finger pumping the trigger for the short bursts, three-four at a time. The black and white Kaffieh was just ahead and the rest of the body was  shielded. The sun's rays highlighted everything, the grey basaltic boulders, the eye-slit in the Keffieh, the Kalachnikov barrel jumping up and the fireflash issuing from it. The range shortened impossibly slowly, then the head blew apart and the brains spattered, and the Kalachnikov barrel pointed skywards. The machine gun was atop the boulder and a lone hardy man was trying to rotate it towards the storming troops. The Tavas was now fully open, feathers spread, spewing fire and they assaulted onto the machine gun emplacement. And then it was over, the Tavas overran the position and the man was draped over the gun, blood slowly pumping from a big hole in the neck. Yossi looked right and left but there was no one standing or hiding  and his troops were all safe. He started breathing again and realized that he had stopped breathing right after the FOLLOW ME scream.

 Suddenly the road below was alive with Jeeps and command-cars and soldiers who converged on the small hair-pin turn. The Thwap-thwap of the helicopter came over the ridge. Yossi felt like he weighed a hundred tons and his helmet was a dead weight, and his knees nearly buckled under. He turned the safety on and called his troops together. They all looked beat, loosened their helmets off, and observed their handi-work. Four men, creatures in the form of the Lord, were reduced to insignificant bundles of flesh, wrapped in bloody garments. Lieutenant General Matti Cohen, in green fatigues, jumped out of the leading Jeep and stormed up the hill. Behind him, the Engineering bomb-squad approached the explosive device carefully. Matti came up and demanded "any casualties?”

"None sir" said Yossi, finally beginning to grasp the achievement, this group of guerrillas had been the terror of the transports for months. He was awash in relief. 

"So what's this?" said Matti and pointed at Yossi's own sleeve. It was sodden with blood and suddenly Yossi felt the sting  and pain spreading from his upper arm.

"Oh it's probably a scratch" he replied lightly, "Jonathan will take care of it on the spot."

Jonathan, who had emigrated to Israel from South Africa, went back for his medic bag which he had discarded before the battle, and produced the scissors. Yossi sat back on a boulder and looked semi detached as the sleeve was cut and the gash exposed. It was really beginning to hurt now.

"The bullet went through, it needs to be stitched" Jonathan told him breathlessly.

"OK, put a bandage on it for right now, don’t exaggerate" Yossi told him off testily.

 

The hillside was starting to look like a football field after the win of the home team except that everyone was in olive-green. The helicopter landed nearby and now it was another senior officer who lumbered up the hill, surrounded by a veritable army of senior officers, radio bearers, intelligence etc.. The local   villagers came out and watched the Army people milling about and two  lines of cars, donkey-carts and lorries formed behind the road-block placed in both directions. His wound dressed, Yossi described the short battle, was cross questioned frequently until he had the whole picture. Other soldiers collected the armamentarium of the dead guerrillas and others picked through their pockets to look for identification and organizational affiliation. They were Islamic Jihad, and they carried orders from  Fat'hi Shkaki, the military chief of the Jihad. Yossi left that part to the experts, it was time to extricate his troops from the Victors Hoopla and come down to earth. Major Levy, the grizzled veteran  company commander,  gave him his nod. Anyway, he felt a little disgusted with the whole bone-picking-after the fact deal.

"All right you couch-potatoes, breakfast is over and it's time to continue Tavas, we are scheduled till  eleven AM and its only eight O’clock." Kadosh and Eitan looked at him with dismay and started protesting. Yossi steadied his gaze on them and the protest died down. 

"Line up for Tavas" they lined up along the road, each checked their magazines, the medical bag, water and grenades. Yossi checked each weapon for safety on, and then he strode down the road. His Gallil soon settled into the usual position, horizontal across the belly, pointing left, right hand resting lightly on the handle, metal stock under the arm, and the left on the barrel, both elbows at 90 degrees. His pace quickened and soon the characteristic swinging gait, butt pumping and arms on the weapon, reestablished itself. This was the seven kilometers per hour gait that ate up the distances while the mind flew to other regions. Tavas spread out behind him, emulating the gait and pace of the leader, heads high, scanning the houses that sprouted on either side of the road. Yossi looked back and his chest expanded at the sight of the troops. The job was a stinking job, but the men were 100 percent, and then some. He was proud to be at their head. Now the Tavas was showing the Flag. This village knew what had gone on only a mile out of town and they knew that these guys were not to be messed with. As they walked though the center of the village Yossi could feel the resentment, and the hate emanating from half-opened windows, the dark staircases, and the veiled eyes of the hooded women. All this was a folly and it had to stop - but not today.

 

The last shop in town was a coffee shop and the old men were already sitting at the low copper tables drinking thick black coffee from tiny porcelain cups. Yossi nodded in a friendly manner and flexed his shoulder which now sported a cut-off sleeve and a thick blood-stained bandage. He turned off the road and climbed the hill behind the last houses towards the trees half way up the slope.  It was time for late breakfast.


Even in repose they were not relaxed. They had their Gallils propped across their knees, and pulled out the water canteens. Kadosh fished for some sandwiches from the Grenade ruck-sack. Sam opened a spare magazine pouch and pulled a folded Iraqui Pitah and dug into it with gusto. 

 

Yossi sat on a terrace-stone a few meters above and surveyed the countryside from his vantage point. His water-bottle actually contained  cold coffee and he relished the sweetness that flooded his mouth. The sun climbed higher and it was a wonderful day to be alive. The extra magazine pouch yielded a chocolate wafer which appeared pulverized, probably due to the early morning antics. He opened the wrapper and gobbled up the wafer dust that spilled out. The breeze was soft, and the cherry trees produced a sweet shadow and everything appeared etched in sharp relief. He saw a young girl on one of the flat roofs,  hanging some clothes on a line, and pulled the eight power binoculars. She came into view, a sinuous figure, her hair uncovered, falling in  long wavy black stresses down her back. The hair shone in the sun and he was captivated. Yossi thought of calling the troops to the sight and then felt almost jealous . She was his, if only for a second, across three hundred meters of line of sight. The girl turned and looked right at him, although there was no way she could see him in the shadow. She smiled and talked to someone and then disappeared into the house. Yossi put the binoculars down and suddenly tensed.

The back door of the building which he knew to be the coffee house, the same building on which roof the girl had done her magic, opened, and a man came out. Yossi immediately scanned him with the binoculars  and saw a tall man, dressed in a long white Abaya and the Keffieh, checquered in black and white coiled on his head, leaving his face open for inspection. It was a handsome middle-aged face with a handle-bar moustache. He had a grey blazer on and carried a flat copper tray perfectly balanced. The tray returned a blaze of sun light, and there were 7 cups and a carafe of polished copper with a thin spout and a long round handle. The man started ascending the terraces and approached the troops. Yossi pursed his lips and uttered a short whistle. The soldiers looked up from their food, then grabbed their guns  and pointed them towards the lonely figure. The young girl appeared on the roof again and cried something. The man ignored the cry and pushed on up the hill. The soldiers spread out in a semi circle.

"What's going on?" Eitan asked Joe who maintained his outward calm.

"Don’t know, maybe he wants to offer us coffee."

"Fat chance" Eitan guffawed and was joined by the rest of the Tavas  “next he will offer us his daughter, ha-ha." Joe crinkled his mouth but his eyes did not smile, and the slits became  narrower. He left his Gallil where it was, a stick resting on a stone. The man came up and passed Jonathan who followed him with his gun barrel, and, short of breath, came up to Yossi. Yoseph Bergman steadied his gaze through those dangerous narrow eyes on the guile-less face.

The man did not speak at all. His deep-brown left hand supported the burnished beaten copper plate and his right held the carafe. He poured a small measure into  each of the small white earless cups, thick black hot brew which wafted vapour in the cool air under the cherry trees. The smell of fresh brewed coffee was intoxicating. He looked at Yossi and Yossi gazed right back at him. The man placed the carafe in the middle of the plate and took one cup . He sipped the coffee daintily and looked at Yossi again. Yossi smiled hugely and took a cup. The coffee was strong, sweet, and delicious. 

"Come on  guys, be courteous, take some coffee" Yossi said loudly. One by one, initially with suspicion and then with relish, the soldiers lowered their weapons and came up to the aromatic brew.

 

"Assiez avec nous, Monsieur s'il vous plait" Yossi's french was high-school stilted but in Lebanon the French influence had been very strong and it was likely that an educated local would understand.

"What is your name?" Yossi continued.

"Je suis Ahmad Abu Rabi'a and I own the Cafe that you go by every day." Ahmad's voice was quiet, mellow, well enunciated French with an Arabic accent.

"Et moi je m'appelle Yoseph Bergman, Merci Bien pour le Cafe” continued Yossi "but why?  This has never happened to anybody in this sector."

Ahmad paused and looked down to the village spread  along the narrow road and haphazardly over the hillside.

"Because your group here is different, you never harass anybody like some other patrols, you leave us alone as long as we leave you alone, and you don’t act like you own the place. I thought some common courtesy would be a nice change especially since you are sitting in my orchard, and doing no harm, that makes you my guests." Yossi quickly translated and they shifted a little uncomfortably. Suddenly each of them thought of how  it would feel if a strange armed person would start walking around their back yard.

"On the other hand" continued Ahmad "I am not sorry you gave the Palestinian Jihad some of their own medicine. Do you have any idea how these people harassed us before you came? They made the women wear Nikabs, they beat up on enfants who did not go to the mosque on Friday, they evicted families from their homes to establish bases, we would gladly be rid of them and the Israeli army, but Lebanon is too weak  to resist occupation by some foreign force" he added bitterly.  "If it’s not the Palestinians, it's the Iranians or Syrians." Yossi nodded with understanding while sipping his coffee and translated for the troops. It was quite wonder-ful to see how their expressions slowly morphed from suspicion and a little xenophobic fear, to understanding and empathy.

"Monsieur" said Yossi "we have no wish whatsoever to be here and if I am not mistaken no one wants to be here unless as tourists. It’s the Government which is making a huge mistake, that is sending us here, and we try to be as humane as we can while here. On the other hand I can tell you monsieur that life in Kiryat Shemona and Nahariah just south of the border was terrible as long as the Fatah was doing the Katyusha work every day, and that’s why we were sent" Ahmad listened and sighed.

"Le problem est, monsieur le Capitain, That we are all little people who do not have much influence over the Government, what can you and I do?”

Yossi  replied very seriously "first we can do something by being Humans while we are here and Primum Non Nocere as I was taught in Medical School (first, do no harm). Secondly, the citizens of Israel are not going to tolerate this folly for much longer. I expect a withdrawal within a year, see if I am wrong.”

A high pitched yell broke through the air, and Ahmad shifted his attention to the roof where his daughter was gesticulating.

"I must leave" he said quickly  "don’t stay too long, some-one may see." Ahmad collected his porcelain cups, each rimmed with coffee granules and quickly strode down the hill, around the terraces. They all followed him, a solitary figure disappearing down the slope and the spell of friendly conversation broke. The Tavas hefted their loads and rifles and groaning they resumed their trek up hill.

They had just crested the hill and started down the other side when the sound of 3 rapid-fire gunshots erupted. Yossi whirled and then his face contorted with rage and he started running wildly back the way he had come. The Tavas wheeled around and followed their suddenly mad leader. Yossi was racing down the hill like a leopard charging toward his prey, around the trees, over the boulders, over the terraces. It seemed impossible that he would not slip, or stumble and fall, but he did not. The Tavas could not keep up and Jonathan screamed at Yossi to slow down but he did not. He reached the wall separating the house from the orchard and leaped over it with a mighty bound. He soon disappeared around the house. Silence. Then the shriek of a young woman pierced the air and went on and on with whoops to take more air and shriek some more. The Tavas rounded the corner at a dead run and stopped in their tracks.

Ahmad was lying in the middle of the narrow street, obviously shot at close range, and his daughter was on her knees shrieking her head off. Yossi was at his side feeling for the pulse at the neck and shaking his head, his face a mask of rage and sorrow. "Spread out" he yelled at his immobile troops  "someone shot him and they may still be around. Eitan, get  Company on the radio."

"Yonah1 from Tavas Red."

"Reading you 5 Tavas Red. over."

Yossi grabbed the mike "we are on the west end of complex 'Yaarit' " he referred to the names given to the village on the IDF code map designated  SECRET, "we have a  man shot here, send ambulance and reinforcements."

"Who is hurt Tavas Red."

Yossi exploded "What does it matter who is hurt!! send it right away, over."

"OK, OK keep your cool, I'll call KodKod right now, This is Yonah1 over and out" squeaked the speaker.

"Tavas Red, this is KodKod , who is down?"  That was  Major Yacov Levy, the Company commander.

Yossi was already busy tearing off Ahmad's clothing to reveal the three entry wounds, one to the chest, one to the belly and one in the shoulder. They were inaccurate even from zero range. He decided that he must move Ahmad away from the middle of the street where any sniper could pick them off, so he and Jonathan quickly scooped the wounded man and dragged him to the shade of the deserted Café. Jonathan  opened his medical bag, and spread out the IV fluid bag and started  looking for an IV site. Joe motioned to Ami and Kadosh and   Sam to watch for  hostiles and felt for the pulse again. It was steady but weak and thready. The girl stopped screaming and watched wide eyed the soldiers taking care of her father. The street was otherwise deserted, everybody else ran for cover as soon as the shots were fired, and Ahmad would have bled to death right 

there. Eitan answered the call.

"KodKod, this is Tavas Red, it's a local."

"Tavas Red, this is their business leave the place immediately."

Yossi took the mike. Jonathan  found an IV site in the  neck and stuck the Venflon into it. He removed the steel needle and slid in the plastic catheter. He secured it with tape and connected the Saline fluid to it. Yossi said "let it run" and Jonathan recalled that Yossi was a  medical student. Yossi  was more composed now and replied.

"Kodkod Yonah This is Tavas Red, he's a local contact and there may be other armed hostiles here. We must search the village NOW."

"Roger that Tavas Red, we are on our way, doctor from Battalion will join us."

Jonathan was dressing the belly wound and the chest wound. Yossi turned to the girl. As soon as he turned towards her she jumped up and screamed something in Arabic, short and hateful, and ran off down the street to disappear into one of the bare buildings. Yossi looked after her with a grim face and stopped Ami who moved to pursue her. "Let her go Ami, I guess she thinks we are responsible for her father's injury.”

 

The convoy of Jeeps and Command cars and a couple of APCs roared into view. The drab-grey ambulance with a Magen David painted in red came up and stopped by Yossi  and Jonathan. The medics jumped out and under the direction of Doctor Yigal placed the wounded man on the stretcher. He appeared to be stable, loss of blood but no foaming at the mouth. Soldiers were everywhere, running into the buildings and searching for firearms. This was a nasty business of breaking into people's homes and searching through their property, upturning beds, rolling over sick elderly, and going through closets to look for guns and grenades. Yossi became numb, this was too much for one day, he and his Tavas needed to be relieved.

"Busy morning, eh?" Yacov Levy slapped Yossi's  shoulder, right above where it still stung from the early morning assault. Yossi winced.

"Yeah, get us out of here OK?" he said.

"Hey, you earned it, You guys are gonna get the day off, I wouldn’t want you to use up all your luck in one day." Yacov gave Yossi his well-used  grin. "Go on the second command-car and keep your eyes skinned." Yossi nodded, Ahmad  was  in good hands and maybe the terrorist who tried to kill him solely because he had carried a civilized discourse with Israelis would still be caught. Not that it made any difference. For each one you got there were a thousand who walked around with a death-wish. This country drove you crazy, so pretty, yet so dangerous, full of people so different, some tolerant,  most hateful. Yossi wished he was not mired here with the rest of his generation.

The Tavas folded wings and tail and climbed aboard the open command-car, six hard seats set back-to-back, guns pointing out. One could not let one's guard down even for a second in this bloody country.

 

This had been the twilight of the Invasion. Yossi had no idea that one day he may need come back to this accursed place. And he was very wrong about the withdrawal. 15 years later the Israelis were still mired in Lebanon, fighting the same war, only the enemies had changed names. If it was not the Fatah, then it was the Hezzbolah, backed by the fundamentalist capital of the world, Iran. But it was all the same. Fanatic Islamic terrorists devoid of inhibitions versus a modern army hobbled by humanitarian principles.

 

 

The only beneficiaries of the Invasion were the migrating birds, the Eagles and the Herons and the Ducks, which, from times immemorial, migrate south in fall to their African winter grounds over Turkey and Lebanon and Israel.  When Fatah-land was abounding with guns, the birds were shot at and downed for their feathers or to relieve boredom. Once most of these guns were confiscated and the illegal ones kept under wraps the  yearly Golden Eagle count which was run by the SPNI in Israel, after long years of decline,  began to increase from 1982. The Human casualties continued to mount inexorably.

 

 

 

 

 

 

 

 

 

Evening Terror

 

The 4 year old child was panting and crying and sniffling all at the same time, eyes wide with fright. The exam room was strange, scary, with a smell reeking of Hospital. Worse, his mom appeared to be as scared as he was, maybe more, and he didn’t know why. Only a few hours before he had gone for a doctor’s visit to his pediatrician’s office, that bright cheerful place with the big fish-tank, the colorful fish and the little sunken castle. He had his favorite panda bear with him as he always did when going for shots and that place was not really scary even if he did have shots. But this place was huge, and terrifying, with strange sick kids with no hair in the playroom, and he wanted to go home right now. This scary blond nurse  was trying to calm him down in a low soothing voice, but he was not going to go quietly. He took a deep breath and screamed in the highest pitch he could muster "Mom I want to go home" over and over again.

 

Doctor Joe stepped into the room, closing the door softly behind him. He looked at the screaming child and took in the familiar tableau, the small procedure room, the white walls, the wash-basin, the gleaming steel equipment racks, the exam table and the frightened mom holding on tightly to her child's hand. He smiled his most reassuring smile at her, practiced hundreds of times in similar situations and said:

 "Hi, I am doctor Joseph Bergman, and I am the Pediatric Oncology fellow, are you Mrs VanLeiden?" He extended his hand. Mutely she took his hand by the fingers only, noticing a wedding ring on his left middle finger. "Doctor Oppenheim from Appleton called me a few hours ago and said that we have a little problem with....he glanced at his clip-board with the new sticker on a scribbled page "Robert here." He turned to the child who had stopped screaming and looked at the newcomer with huge round eyes. "Can you tell me about it?"

 

 

As the story, variations of which Doctor Joe  heard two to three times a week, came forth, Joe busied himself with examining the 4 year old. He worked quickly top to bottom, noticing the pallor of the conjunctiva, the quick moving eyes, the supple neck, enlarged lymph nodes, the spleen that protruded 5 centimeters below the costal margin, and the multiple bruises on the shins and above the knees. Mrs VanLeiden talked about the tiredness that overcame her usually active child, the refusal to eat, the vague complaints of leg pains, the initial doctor’s visit where the child was given some iron syrup, and finally the appearance of the bruises on his fair skin, without any playful activity to explain them away. She was recently divorced and Bob was her whole family nest. Joe let her tell her story with little interruption, knowing most of the information from Dr Oppenheim.

When he was done he said: "Mrs VanLeiden, you already have an idea that we have to do some tests to help us figure out what is going on. We will do everything under Conscious Sedation so that Bob here will feel the minimum of pain. Will you let me do those tests?"

She nodded, his courteous reasonable voice doing the trick of inducing calm to tense situations, she couldn't place his accent though, it was not Midwestern, that was certain. He did not even appear American but he did not fall into any of the usual categories of foreigners. He must be from the East Coast she decided in her mind. Karen, the charge nurse, produced the standard Informed Consent sheet and a Bic pen and she signed it.

 Joe then turned his attention to little Bob. "Versed" he said shortly to Karen. She handed him the small syringe. He squirted a tiny amount of the clear liquid into the kid’s nostril. After a short while his new charge's eyes turned sleepy and he prepared for the IV.

Having established an intravenous line with a minimum of fuss he prepared the Bone Marrow Aspiration tray and the Spinal Fluid tray. The door opened again and Mark Haily, the medical student, came in. Joe, without turning around,  said:

"Mark, will you please take Mrs VanLeiden to the parent’s lounge? It’s at the end of the corridor, and come back here."

Mark opened the door again and led Mrs VanLeiden softly to the room marked Parent’s Lounge where there was a coffee machine always ready with coffee of indeterminate vintage. He turned and almost ran back to the procedure room - he didn’t want to miss the initial workup of a new Leukemia.

 

 

The Pulse Oximeter was already beeping quietly, the green screen showing a strong pulse and saturation of 98%. Joe had the green mask on and was prepping the puncture site at the hip-bone crest with Betadine. As he swabbed the skin in concentric circles he took the opportunity for some teaching.

"What did I give Robert for sedation purposes?” Joe asked, sounding didactic.

Mark was ready for that one "Versed" he said.

"Why choose this medication?" Joe countered.

Now I am in for it "because it is short acting and because it induces amnesia - I think" Mark replied.

"And what is the main danger?" Joe continued the quiz.

"It may decrease the respiration" ventured Mark.

"Very good, so please give Robert zero point two milligrams to keep him where he is" Joe grinned and prepared the Jamshidi needle. Mark watched as Karen tensed her hands on Robert's back and legs under the blue sterile wrap. Mark observed Joe closely. He was just under six feet tall, powerfully built with wide shoulders, long arms and a tremendous grip. There was just a suggestion of fat around his middle and stout legs with size 14 shoes.  Mark estimated Joe at 220 pounds. He had the obligatory pair of round glasses, definitely not Armani, resting on a shelf above the  straight unremarkable nose, and green-brown eyes. It was a typical doctor’s face except for those weather-beaten eyes. With a short twisting motion Doctor Joe inserted the needle into the bone. Bob twitched and whimpered. Joe used the 10 cc  syringe to pull just a little bone marrow, which came frothing out. The sudden vacuum in the syringe forced a quick cry of pain from the child, and Doctor Joe quickly spread the drops on the glass slides prepared in advance. He turned back to the needle and slowly withdrew 15 more CC into syringes prewashed with Heparin. Gently the needle came out and the wound was covered with heavy gauze and tight adhesive bandage.

 

Next, the collection of spinal fluid. Joe marked the space between the vertebrae with his gloved thumb. After prepping the proposed site with Betadine Joe concentrated on the 2.5 inch needle. With a swift jabbing motion he inserted the needle right on the mark and advanced it until he felt the 'pop' of the Ligamentum separating under the pressure of the needle. The steel stylet came out and clear fluid issued from the hub of the needle. Joe handed the sterile plastic test tubes to Mark as the fluid came up to the one centimeter mark. Finally he connected a small syringe to the needle hub and pushed in the first dose of chemotherapy right into the spinal canal. He pulled the needle out and quickly laid his small patient’s head down to facilitate the movement of the chemo towards the fluid bathing the brain itself. Mark watched the proceedings in quiet fascination. Karen, for whom this was the routine, watched with proud approval, she needed to protect every patient from bumbling doctors and this patient was in good hands.

 

Doctor Bergman rose from the metal stool and collected the tubes. On each pre-stamped sticker he wrote the destination because each sample was essential to the process of diagnosis and prognosis. Generally he could leave routine samples for the lab distribution system, but these samples were too valuable to allow casual treatment - he believed in no one when it came to initial diagnosis of Leukemia, the hopes and grief of people were totally dependent on the content of these tubes so he preferred to take them himself. Little Robert began to shift and move and then to cry, and Joe knew it was safe to leave him to Karen. Leaving the procedure room, Mark and Joe walked quickly up the corridor to find Mrs VanLeiden sobbing into the Kleenex provided by one of the parents who inhabited the room while their children  received chemotherapy. The parent's lounge was shadowy and lit only by one lamp so that another parent could catch a nap in the corner settee. Joe just touched her shoulder and told her that the procedure went very well and that Bob was waiting for her. Then he turned on his heels and strode out, already intent on the next stage.

 

Mark found that he almost has to run to keep up with Doctor Joe. Not that he appeared in a great hurry, but his steps were long and his butt was moving like the long distance walkers Mark saw on TV in the Olympics. Mark also noticed a strange arm position that Doctor Joe always assumed when setting a quick pace, elbows held and 90 degrees and with relatively little vertical movement.

They reached the stairs at the end of the corridor and Joe just kept on the same momentum down the stairs taking them two at a time. Joe distributed the tubes to the various labs and kept the Last to the end, The HematoPathology lab. The glass slides he has made he gave to the tech on call to stain with Wright Giemsa stain. This would take about thirty minutes and in the mean time Joe and mark headed for the big double-headed microscope.

 

Joe pulled a small cardboard envelope and extracted two glass slides which came from Dr Oppenheim, along with the new patient. Mark had never seen the blood picture of a new leukemia. He did see many blood films in previous rotations but felt apprehensive of facing a blood film with such consequences. Most of all he feared disapproval as would project from Joe if he did not see whatever it is that needs to be seen. More than anything Mark wanted to win doctor Bergman’s approval, and the only way to win it was through knowledge and understanding of patients and the diseases that brought them to the Children’s Hospital. Not that  Joe ever censured him, but upon hearing either incorrect information or worse, cover-up, he  would raise his left eyebrow, drop the right, purse his lips slightly and start pouring out the straight dope with the appropriate references. Mark quelled his apprehension and applied both eyes to the double lenses. Joe first looked at the field under low power, chose a good spot, dropped one drop of oil on the glass slide and rotated the lense to the 100 power enlargement.

They came right into his field of vision, blue stained, evil, killer cells, each one as menacing as his identical clone. They filled the field from end to end, leaving no room for normal cells. He looked at them, fascinated by the sight of the Enemy staring at him through the lens.

"Mark, please tell me what you can see" said Doctor Bergman.

Mark took a deep breath "I see leukocytes ...”

"Hold it" commanded Joe, "start from the beginning, from the general appearance of the field and then work your way to the description of the Blasts."

"All right, the field appears to be well stained, the cells do not seem to be overlapping. The red cells appear normal with a discoid shape. The leukocytes are uniform with no variability. Each has a large nucleus and granular cytoplasm er... "

Joe smiled, this was very good for a first effort and continued "the cytoplasm is abundant with secondary and primary granules, and one can discern Auer rods in each of them.  So what do you think we have here?"

 

Mark was lost, his brain ground to a halt, if Joe had asked him his own name he would not remember it that very moment. A few seconds of complete bewilderment overcame him and he felt his face flushing, and then the coin dropped; The word 'Auer' clicking that safe-lock that he felt his brain was locked in, and he blurted "Myeloblastic Leukemia" through  a dry throat. He then lifted his eyes to see Doctor Bergman grinning at him. Joe landed his paw on Mark’s shoulder with a convincing slap "good, good" he said and Mark winced just a little. Joe was different, he gestured freely with his hands and occasionally landed a hearty cuff. On the other hand he was the best teaching Fellow in the Service. Joe then proceeded to talk about the methods of further diagnostic means and the strengths and limitations of each laboratory.

By and by the 30 minutes were up and the Bone Marrow slides were ready for viewing. The picture was more complex but the essential finding was the same-Myeloblastic leukemia, a disease with only intermediate chances of cure. The final diagnosis would rest with the laboratory results that would only be available the next day. It was time for the most difficult task of all, facing Mrs VanLeiden and telling her the bad news. Despite 6 years of experience in either watching, or performing the terrible job of transmitting horrible news to parents Joe never got quite used to it, and dreaded again and again the inevitable "Is he going to die, Doctor" question. He became aware that Mark was huffing and puffing behind him as he ascended the steel staircase to the seventh floor just like he descended it, two steps at a time. He slowed down somewhat and controlled his own breathing as they approached the parent’s lounge. He stopped by the house-phone and called the front desk of the ward. He asked to send Karen to the parent’s lounge. Karen was present during many of these sessions and could steer him away from thin ice.

 

Joe waited by the house phone and watched Karen walking quickly towards him. Idly he wondered what she was really like behind the professional facade she always displayed in his presence. Actually he almost never saw her participating in the girl gossip that the nurses engaged in as they did their charting at the end of their shifts. She would do the paperwork efficiently  and spend the rest of her time with the kids. She would take a pack of cards and play with the teenagers who had incredibly complex limb-sparing operations for bone tumors. She would  paint with the Paintbrush on the portable computer with the 6 year-olds with Leukemia, and she would go over the resident’s orders with a fine-tooth comb to maximize pain control. As she approached Joe felt the faint stirring of something he thought he had suppressed - and immediately felt the self disgust welling up within. Back to earth, man, he commanded himself and arranged his features in a non-committal not-quite grin.

 

Karen looked very seriously at him, "This mother is not going to tolerate much, Doctor Bergman" she said quietly, her voice full of concern, soft, Mid-western. "She is alone, divorced, and her own parents denounce her for the breakup of the marriage. He left her with nothing, nothing, and they recently moved to a trailer park. Bob is all she has, and her job in the Bergstrom paper-mill. Her coverage is adequate though, they were enrolled in the HMO through her job. What’s the word, is it a straight forward  ALL?"

She referred to the most common subtype of childhood leukemia for which there was an excellent chance of cure. Joe pursed his lips and shook his head.

"Probably AML, but I will know tomorrow, they will not do the FACS tonight unless it's an emergency and although he is sick, he is not critical, and all his other parameters are stable" Joe referred to the set of routine lab work obtained from Bob previously. "Let’s see if there is anybody in the lounge" He let Karen precede him into the room, her short flaxen hair just brushing by his nose.

They found the small crushed bundle that was Mrs VanLeiden, essentially a mousy 30 year old woman with brown hair, large brown eyes all sooty with tears, crumpled in the corner, where the only lamp cast shadows on her tear-streaked cheeks. Karen lowered herself gracefully beside her on the settee and draped her arm on the thin shoulders. Joe dragged a multicolored Green-Bay chair from the door and faced her. Mark stood unobtrusively at the doorway.

Joe felt the tightening of his breath, the choke in the throat and said:

"Mrs VanLeiden."

 “Mary, my name is Mary” She said in a small voice.

"OK Mary," said Joe gently, voice low and soothing, "we need to talk about Robert's problem and I have some more information" oh God, oh God, she is gonna cry and ask the inevitable ...

“Is he going to..going to....” The sobs racked her. 

 “No Mary, he is not going to die and we are going to try and cure him, and I need your help to do it. He will need you to be strong for him" his voice hardened somewhat, kinda military thought Karen, "and we will give you all the help you need, but Bob will need you, now more than ever. Bob will look to you and if you are in despair, he may despair too. Children feel with their parents, and you must remain steadfast for him."  Karen thought that Joe spoke above people’s heads sometimes, but Mrs VanLeiden appeared to heed, she stopped sobbing and listened intently to the rest of the Talk.

 

Doctor Joe told her about leukemia, about the effects on children, about chemotherapy (no details yet, the disease subtype was still an unknown) and about the Central Catheter that Bob would need. He wound up the talk with words of hope and encouragement. Karen nodded slowly with approval. There were as many styles of imparting bad news as there were Doctors, but Joe's style was unmistakable, it almost sounded like the Major preparing his company for battle against the real enemy, Leukemia.

Mark was fairly shaken by the emotions in the room, and Joe had to tap him on the arm to break the immobility. They filed out of the lounge and headed for the nurse's station. Joe pulled the new chart from the rack and filled in the H and P, in a slanted hand writing. This was only a summary because he intended to phone in the History and Physical directly to the dictation service. He also paged Amanda Carter-Halim, the fellow on call for the night, for whom he covered for the past hours so that Amanda could finish an experiment in the lab. The tissue cultures were finicky and he knew that the work must be completed and could not be finished at 5 o'clock just to suit the accepted knock-off time. Anyway, Home was not much since... He forced his attention back to the page and was just done when Amanda called in.

“Hey, what's up?” her cheery voice came down the line.

 "Are you done with your funny cells?” Joe asked playfully.

"Yeah, I just put them to sleep for the night in 5% carbon dioxide, and I won't see them for four days thank the Lord, anything that will bother me tonight?”

Joe launched into a quick check-out monologue while Amanda scribbled the essentials on her clipboard. He finished by describing Bob and his mother "nothing for you to do tonight. Karen is with them now, I see her coming, I’ll get off the phone now."

"OK, G'night, come back tomorrow" Amanda plunked down the phone, satisfied with a job well done. You could always count on Joe to help in a pinch as long as you didn't take advantage of him.

 

 

Both Michelle and Tommy, the nurses who were usually on the afternoon shift ganged up on Joe with various requests, Can I give Johnny an extra dose of Zofran, he has been nauseated all evening, Buddy has not put out enough urine since three and he is still getting Cytoxan. Joe dealt with the questions curtly and with authority. He knew that most of these questions could have been answered by the resident, but she was new in the rotation and was busy admitting a routine admission. Karen passed by, and filled in her nursing notes.  She flashed a smile, and as she was sitting under the clock he saw that it was already eight o'clock, way past her sign-out time. She would have to be back at 0700, man, she was such a concerned nurse. Lastly, Joe looked at the counter in front of the nurse's station. He found Doctor Horowitz’s phone number posted up and punched his number on the phone console.

"Dr Horowitz residence"  came a piping voice, "who is it?”

That must be Debra "Can I speak to Dr Horowitz, it’s Joe at the Hospital calling."

The phone changed hands and Joe picked up the receiver "Dr Horowitz, it's Joe here, we admitted a new AML, tonight, the one Oppenheim called you about. The BM and LP are done and the labs are doing their stuff. I don’t think you really need to come in" he told the attending physician. Dr Jay Horowitz cross questioned Joe for a minute, verified the lab work, the fluids, the medications, surgery consult for the next day. He trusted Joe implicitly, but anyone can forget an important point or overlook something. He was the attending and he was ultimately responsible.

“How is the research going?” Doctor Horowitz asked.

 Joe sighed “it’s slow, the statistics take real concentration.”

“Keep at it mate” Doctor Horowitz encouraged him. He liked to style himself an Aussie.

 Joe placed the handset back and went into the back room where he found Mark buried in a big book. He clapped Mark on the shoulder and said "Mark my man, you need to know when enough is enough, go away. I promise no grilling tomorrow or Monday." Joe went for a Goodwill type of trench-coat hanging in the corner, extracted a balaclava-cap with Yamaha emblazoned on it, "this is a reminder that summer will come and I may ride again" he grinned at Mark, a weird grin Mark noted, the mouth smiled but the eyes did not.

 

 

 

Karen gave her scarf a last wind around her neck before stepping outside. Wisconsinite or not, November was cold and the weather report on the five o’clock news was dismal, temp of 25 and a wind chill factor of 5 degrees. She thought of waiting for the security escort, but she was a big girl and that escort may take his own sweet time about appearing. She wished for the deep bath she would draw at home and Beethoven on the stereo, and so she pushed the weather-tight door and ventured outside. The wind hit her with her icy claws and she felt the top of her ears recoiling from it but she went ahead resolutely. Overhead there was the overpass which was under construction, which in due course would extend all the way to the parking structure. Right now though,  it  created a heavy impenetrable shadow, blocking the yellowish meager light cast by the visitors parking-lot streetlights. Three weeks before, a nurse who came off duty was attacked right there in the parking lot and barely managed to escape. The attacker was never found, and the Hospital announced that Security would provide escort to the parking lots and structure on demand. All that sounded fine, except that as the incident receded in people’s mind, Security took a little longer to assist individual nurses and doctors. Karen avoided the shadows and walked quickly on the slick tarmac. A sudden movement in the shadows startled her but when she looked into that spot there was nothing. She doubled her pace, passing between the cars until she reached the door at the foot of the entry to the huge concrete parking structure. As she opened the door she glanced again around her, but only the wind tore at the tip of her nose and loosened the scarf from her neck. As the door closed behind her, the sudden absence of wind made the dark staircase almost warm. She did not see the figure entering the parallel doorway 20 yards away. Karen climbed to the second landing, pulled the door and turned left. The wind whined mournfully between the concrete pillars.

 

The arm that came around her neck was as brutal as the knee that slammed into her left kidney. Were it not for her scarf she would have fainted there and then.  Karen did release a thin eerie choking scream that stopped abruptly as the other hand smacked into her mouth so hard that her lips split against her teeth and she tasted salty horrible blood. She swallowed hard and opened her mouth to bite the hand that was blocking her nose and mouth. All she got was some leather and the other hand tightened around her neck so hard she thought her neck must surely snap. The pain from her flank reached her consciousness and a wave of nausea so strong overcame her that her legs buckled under. The arm around her neck tightened some more and her lower jaw snapped up, catching her tongue, more blood gushed into her mouth. The gloved hand withdrew from her mouth and the man began dragging her fast backwards, while her feet dragged on the concrete. She tried to scream again and as she took a breath a blade flashed in front of her eyes and a hateful throaty voice rasped "Shaddap, shaddap, you bitch or I cut you up." His breath stank, her brain screamed 'This can’t be happening to me’ and the knife flashed away to the right. The man stopped behind a rusty Dodge van and half turned so she could see the tow bar bolted to the van. She heard the clink of the knife haft hitting on the door handle and tried to wriggle. The blood was roaring in her ears and she choked on her ruined tongue and she knew that she must break loose now or fear of death will paralyze her. Her legs began to beat on the floor and the grip under her chin tightened some more as the man jerked her around so she looked right into the gaping hole that was the back of the van. The smell of Death rushed out of the Maw at her and she gathered her last reserves to lash backwards with her right elbow. Her elbow sank into the loose clothing and she knew the effort was totally useless. Defeat swelled into her mind and then the deathly grip around her loosened so abruptly that she fell and the black tow bar came up and hit her forehead.  Blackness enshrouded her.

When Karen came to it was not a smooth transition from sleep to wakefulness. She felt as if she was swimming up through filthy salty sticky fluid and that she must take air soon or succumb. Pain rushed at her from everywhere, her head was exploding and she saw bright floaters in front of her eyes. There were two figures in the muddy picture that formed in her brain and she recorded it in ludicrous slow motion.

The man who attacked her was circling, crabbing sideways, a knife held in one hand and the other hand hanging limply from the extended arm. He was hunched forward, bulbous nose thrust ahead and the black sockets seemed to hold no eyes. His face was covered by a thick beard and the moustache seemed to merge right into it so there was no mouth. The sounds that issued from him were low and guttural and menacing. "Cummon cummon you motherfucker" over and over. Facing him, slowly rotating, was another man, dressed in quite a similar manner, with a black balaclava pulled over his face. He was taller and maintained an upright position. His right hand held an implement with a thin shiny stem, with a brush at the end. Karen took a second to recognize it for what it was, a snow scraper, something every Wisconsinite keeps in the car. This man appeared calm and watchful. Meager light was afforded by an overhead bulb somewhere to the left and silent cars were parked all around. The mournful wind sluiced between the cars and blew up the edges of the coats.

 The attacker let out a maniacal shriek and rushed at the man who appeared to stand transfixed. The knife began an arc pointing towards the man's belly. But then the metal handle whipped down hard and the knife hand dropped as if severed. The left hand swung around in a short vicious circle and connected solidly with the exposed neck, the knee came up impossibly high and the bearded face was thrown up and backwards.  The knife clattered to the concrete and lay there. As the body of the attacker fell back the man whipped out his foot in a straight kick with the pelvis jerking into the kick. The attacker was almost lifted off his feet and slammed into the big gray Lincoln his head snapping back and forth. He slowly slid off the trunk and crumpled on the concrete. Karen was almost as shocked by the concentrated violence perpetrated on her assailant, as she was by the attack upon herself. She cringed as the man took a quick step toward her. The light was behind him and she could not discern his features. He crouched next to her, put down the deadly snow-brush now bent at right angles. His large gloved hands came around her head and neck and probed gently -"Don’t move" he said, the voice low and soothing and cultured. Karen was startled, who was it? Her fear receded and the relief was so great she almost fainted again, despite the pain clamoring for attention from every point in her body. She felt a strong arm cradling her head and another sliding under her buttocks and with a grunt she was lifted and carried to the door of the LeSabre. The man helped her to sit and then pushed her down on the sofa-like seat of the big old car. She found that she could not speak due to the sticky mess inside her mouth. The dome light revealed the holes in the cloth of the front seats. The car smelled of gasoline and oil. She heard the man dragging her assailant off to the side. Suddenly he appeared and rummaged in the front, and came up with some cable ties.

"That should keep him secure for a while."  That muffled voice again, where did she hear it before? Those shoulders, she knew them from somewhere.

 

He appeared again, folded her legs to slam the car door and plunked himself at the driver’s seat. "Let’s see if the old lady will start" he said and hit the starter. The old V-8 roared into life "She really loves the cold air" he crowed from the front. Karen held her head tightly against the U turns in the parking structure and the pain beating in her temples and forehead. She pushed her right arm against the front seat to keep from rolling. "We are going to the Hospital" he yelled over the engine. Karen almost laughed, they were practically inside the Hospital. The sickening turns stopped and the car raced up the straightway and made the street corners much more gently. She lost her sense of direction entirely when the car screeched to a stop and the front door opened. The cold air rushed in again, and he bounded out. And then the rear doors were opened wide on both sides and bright light rushed in. Concerned faces glanced in and a gurney wheeled next to the car. She was gently lifted and placed on the rolling gurney and a large blanket draped over her. Karen found herself shivering violently, unable to stop, teeth chattering like castanets. She looked around for her benefactor and could only see the ski-cap moving behind and along with the orderlies rushing her to the big glass doors. They swished open and the hot air hit her face like an open furnace. The sign said Welcome to Milwaukee County Emergency Center. Karen knew where she was.

The orderlies parted and the cap with the Yamaha came off. "Doctor  Joe" she breathed.

Joe gave her a  big bright smile, entirely uncharacteristic,  and said "not a word now, County Docs will take care of you, I am only a Pediatrician and you are WAY out of my league, must take care of your friend up there" he jerked his thumb backwards, "is there  anybody I should call?" She shook her head dumbly. Doctor Joe, the senior Pediatric Oncology Fellow, two and a half years and she knew absolutely nothing about him. The way he disposed of that animal, the same hands that inserted an IV into the tiniest of scalp veins .... Karen shook her head and immediately regretted it, it still hurt so much.

 

 Doctor Joe scooted to the back of the county ED and informed the command center of the suspicious character to be found on the second floor of the Children’s Hospital parking structure. He looked through the armored glass at the Zoo: That was the name given to the room into which the dangerous types came in for medical treatment. He guessed that Karen's assailant may soon be there.

 

He then went back to the ED to find Karen. He found her in one of the back rooms, already drinking a cup of warm chocolate that one of the ED nurses brought her. She managed a wan smile.

 "What took you so long?" she asked, trying her hand at some humor.

 Doctor Joe took the rebuke seriously "I went into the car before you did, I always park on the second level, it’s less crowded. Before I could start the car I heard a noise, a scream, but I was sure my ears were playing tricks on me, so I rolled down the window and listened. Then I saw that bastard dragging someone and flashing a knife. I grabbed the only thing nearby, which turned out to be the snow-brush and crawled out. When he turned you around he had his back to me and that was my chance. You did something to distract him" she remembered the ineffectual elbow jab "and then I hit him on the upper arm where he held you. As soon as he let you go I stepped back, hoping that he will run. He did not and attacked me with the knife. He left me no choice but to hit him hard. That Van may have an interesting story. But enough about this, did he do any permanent damage?”

 Karen listened to this self deprecating story with disbelief "whadoyoumean hit him hard? From where I was this looked like Bruce Lee Kong-whatever stuff”  she mumbled through her lips which were beginning to swell up in earnest now, and her tongue felt wooden and stingy all at the same.  "The ER doc - I don’t know him - said that nothing seems to be broken and he is gonna order some X-rays and have the Plastics people look at me. Where did you learn this stuff and how come I don’t know anything about you at all? and...”

Joe gently stopped her with a index finger to her lips, not actually touching her. "Listen, I need to skedaddle before the Po-lice start getting their act together. Tell them whatever they want. OK?" He turned around, the long trench-coat swishing, and was out of the room before she could react.

Karen just stared at the door, this was too much for one night.

 

Karen

 

One of her recurring dreams was of a long corridor. She was running wildly, and there were doors on either side, always closed. She was running and screaming  "Who am I"  and "Let me in" over and over again and there was never any answer. Karen would have these dreams early morning in the twilight between sleep and awake. Dreams being reflections of day time worries, Karen reflected that this dream summed up her life pretty well, living as she did between worlds.

 

Karen was born to the best the world had to offer. The delivery suite resembled a room in a good hotel much more than a hospital room. The window looked over Lake Michigan, down the slope of Saint Mary's hill. The walls were papered in a soothing shade of gray and a small cross was over the doorway. The furniture almost resembled that of a hotel, and the nurses could teach most bell-men some courtesy. This was the epitome of private medical care in the richest nation on earth, 1968, the United States of America. The Rust Belt was in its hey-day, and the war protests were something that happened in Washington and Madison, most people did not worry about it.

Miriam, the only progeny of  one of the more affluent families in River Hills Village, looked with trepidation between contractions, at the Doctor.  Doctor Berkovitz had the worry-about-nothing-my-dear grin, as always. After all, she was a healthy young woman with no puerperal complications. Her husband, an anxious young man from an equally affluent family from Glendale held her hand and worried anyway. They practiced the Lamaze breathing and performed it in earnest when the contractions came and convulsed the young body.

 

Miriam gaze went to the spot above the door where the Cross was. There was no getting away from it, this was Saint Mary's, it was the best in Milwaukee, and her Doctor who was Jewish, practiced in it. She even married the Cross through her dear husband John, who was Catholic, so the Cross could stay where it was. The religious Jewish couples from the West Side would always take the Cross off the wall for the duration of their stay. In the respite between contractions Miriam mused that the Virgin Mary’s real name was Miriam just like herself. She tightened her grip on John's hand as the labour pain came, this time harder than ever, and a small scream escaped her lips as she bore down. John held her head forward and Doctor Berkovitz exhorted her to push just one more time. With the next spasm, the worst thus far, the baby's head came out and Doctor Berkovitz reversed himself and cautioned to stop pushing, and breath. John was breathing for her and she wanted, more than anything, to push the huge thing that was distending her body worse than anything she had ever experienced. And then came the scream of a baby, lusty, full of life, filling the lungs with air, and her eyes filmed over and she cried tears of relief and joy. John, that reserved lawyer,  was crying openly and kissing her hand, and then nurse Buckley placed the tiny bundle on her belly. "It’s a girl" beamed Doctor Berkovitz, "and she is perfect." With great effort Miriam raised her sweat-drenched and looked at the tiny face, eyes so blue, mouth already rooting for the breast.

 

The holiday season was a most confusing time for Karen. There were always two things going on at the same time. At Grandpa Toby's place right after Thanksgiving there was a wonderful big tree, green with red ribbons and a star on top. Karen loved coming in from the cold, stripping her hat and gloves and coat, and hugging her Grandpa Toby and Grandma Jayne and having her curly hair mussed. Then she would scamper away and dive under the Tree, and imagine herself in the forest just like the Sunday walks in the park atop the backpack that Dad stuffed her into. John loved the woods and the paths along the river and took Karen with him every time. But when she visited with her Grandpa Jacob, there was never any tree. She really looked for it because the Tree was in Daycare, the tree was in the Mall, the tree was in front of the big shop Mom called Marshall Fields and it was EVERYWHERE except  Grandpa Jacob and Grandma Esther’s. So, one Saturday, when she was four   years old she asked Grandpa Jacob. She was sitting on his lap and he read her some story from a big book.

"Grandpa, how come you don’t get a tree just like everybody else?"

Jacob looked up from the book with the brightly painted pictures and cast a sad look after his daughter, the one who had married a Goy.

"That's because we are Jewish, and we do not celebrate Christmas" he said quietly. He knew this would come up sometime.

"What's Jewish?" piped the little one, looking up at him with those huge heartbreaking eyes.

He sighed, that's the most difficult question anyone ever asks. If one had a single Jewish ancestor 4 generations back that constituted Jewishness in the eyes of the Nazi regime, a sufficient justification to put one in the Gas Chambers and convert their body fat to soap, and their gold fillings to bullion in a Swiss bank. If you happened to be the progeny of a Jewish Cohen (priest) and a woman who happened to be a divorcee, that barred you from a Bar Mitzva and a Jewish wedding. So difficult. Explain that to a four-year-old.

"Jewish means being a member of a tribe that thinks God gave them a special mission, Ohmygod, this is WAY over your head. Jewish means we do things a little different, and we don’t have a tree for Christmas."

Karen nodded sagely at that and her attention wandered over to the glass cabinet where shiny cups and other strange implements reflected the overhead light. On Saturdays Grandma Esther always had the light on in that cabinet.  She knew though that she must not open it because Grandma Esther was once pretty cross with her when she did get her hands on the delicate porcelain cup Grandpa Jacob used occasionally.

 

Growing up, Karen was especially bewildered on those Friday nights when they went over to Grandma Esther for dinner. First, Grandpa Jacob was always dressed in his best and had a white cap on his balding pate. Then the table was always set in the same way with large loaves of sweet bread in the middle and wine and grape juice to the side. And the Grace, that was really strange. Instead of being a quiet affair with both hands held and heads bowed just like Dad liked it, Grandpa Jacob sang it loudly, modulating his voice REALLY strangely. Mom would join him half-heartedly, she obviously knew the foreign words, and Dad just stood there mutely, cringing slightly, like he had something bad in his mouth and did not know quite how to spit it out. Karen would look from one to the other and sensed some major tension there, and she sometimes caught grandma Esther looking at her with great pity. Then once the dinner started, everything would loosen up, Dad would become cheerful again and no more strange words and language. With time though she began looking forward to those special Friday nights, the singing, the Special Soup, the special foods and when it was just a plain Friday night at home with Dinner Bath and Bed she would sulk and whine.

"Why can’t we have Kiddush at home? I wanna go to Grandma Esther."

"That’s because they are Jewish and we are not" Miriam answered firmly, perhaps too firmly, "now let’s brush your teeth. I have a surprise for you.”

Karen tried to speak through her frothing mouth, "what is it mom, I want a new Barbie, the one with wedding dress, please Mom, Please!"

"Well" said Miriam “this is almost like a new Barbie, mommy is going to have a new baby, would you like it to be a girl or a boy?”

"A new baby! but Mommy where is the baby going to come from?"  She was full of wonder, her beautiful face turned up to the light.

"The baby is growing inside Mommy's tummy, would you like to feel it?" Miriam stood in the bathroom and guided her daughter's hands over her belly which was just beginning to lose its flatness and acquire a rotund bulge right above the pubic bone. A female bonding moment. There, was that the tiniest little kick? She was only a third of the way through the pregnancy and she did not even tell John yet. She was afraid that indeed this may be a boy and then things will come to a head. Oh God , dear "Adonoi" let this be a girl like Karen, I don’t want to have a fight with John over Identity, Brith, girls are so much simpler.

The pregnancy progressed uneventfully, and Dr Berkovitz performed  a Sonar exam, he was so proud of the new machine. All Miriam could see on the scope was a snow storm but Dr Berkovitz swore he could see the heart pumping, and the abdominal cavity and even the cranium. Miriam was afraid to ask him about the sex of the fetus, it was better not to know. Karen was so excited she never noticed her mother's worries. John was busier and busier in the office and sometimes Karen never got to see him during the day and only in her dreams could she sense him coming up to her bed for a kiss long after she was fast asleep. She did see that the moments of shared happiness between her parents grew further and further apart. Mornings were a rush to the office or to a meeting with a quick peck of a kiss to Miriam and a quicker muss to Karen’s curls. And then one night there was a fight.

Karen could hear them at it and snuck out of bed, across the landing and shivered right at the bedroom door.

"I never said I wanted another baby" her father hissed, it sounded ugly. "I am not ready for another baby, the diapers, the stink, the crying..."

"You never did any of it anyway, I was the only one to wake up to Karen, you hardly ever changed her, or fed her, and I never asked you too. And Karen never stank either. It takes two to make a baby in case you haven't noticed."

"You said it was safe" John was defensive.

"Well, by the time when you were finally willing, it was not." Miriam was all acid. Karen never remembered her gentle mother speaking in this way and she shivered some more. Her eyes were smarting and her nose was filling up and she turned and ran back to her bed. It was just as well because John stormed out of the master bedroom two seconds later. His feet drummed  all the way down the steps, and then the clink of the Drink and glass, an uncaring clink that almost broke the glass. Karen crept back to the shelter of her Eiderdown, but she still trembled, because when her dad drank he would sometimes spank her for the slightest provocation. The closet was just a peek open and the dark slit appeared to widen slightly and the monster with red eyes was pushing the door open. Before it could come out Karen jumped out of bed and scurried as fast as she could to her mother's room. The door squeaked and Miriam, ashen-faced in the gloom, held her arms out to her and enfolded her into and onto her growing belly. The monster stayed away and she fell asleep secure in her mother's arms. Miriam lay quietly and stared at the ceiling until daybreak.

 

In the colder climates animals are usually born in the spring, at a time that Nature allows for foraging for food. Although Humans believe that they are immune to the natural order, it is obvious in Wisconsin that babies appear to arrive in the greatest numbers in the spring. The shoots were just beginning to show on the bare trees, with just a hint of green, when Miriam woke up in the first light of dawn with a weird feeling that she has just wet in her pajama and in fact in her whole bed. Then the cramps hit her like a sledge-hammer, her belly was being twisted and squeezed by a giant hand. She fell back in the bed and winced and bit her lip, and groaned and tried to call for John, and then slowly the cramp dropped in intensity, the sweat rolled down her forehead and into her eyes and through the smarting fog she could see Karen standing at the foot of the bed, mute with horror. Miriam tried to smile, but then the harder truth hit home: John was gone, she was alone with her daughter and the next cramp was imminent. She dragged herself out of bed, her pregnancy (now slightly reduced) creating a constant drag, like a tanker in a small harbor. Who could she call, she thought wildly, John has not answered her calls now for weeks, she could not bring herself to call her mother, it was too early to call the Doctor…then the next cramp began starting from the top and arcing down and she found herself on the carpet and bearing down and huffing the familiar rhythm  of the Lamaze. She could feel the head of the baby distending and tearing at her low pelvic insides and she was seized by panic. She was about to scream when her daughter’s face swam into view. Karen was not mute anymore. She was holding the oversize receiver to her ear, her face resolute and her right index was dialing the black phone. And then, as the labour peaked, she could no longer hold back the long agonizing scream which escaped her clenched lips. The scream was heard on the other end of the connection, and Jacob Lifshitz swung into action.

Esther went for the phone as Jacob threw on a coat and rushed to the garage. He hit the wall button to open the double garage doors and wrenched the spanking new 1975 LeSabre door. The new engine roared to life and he gunned the engine, the car was always parked facing out for a quick getaway, one never knew when the Nazis were going to come, old habits die hard. The wheels whined for traction as he twisted the wheel and he avoided the snow-pile from last week’s snowfall. This car was GRRREAT. The twisting village roads he knew by heart, and he was soon out of River hills and into Glendale. He crossed Good Hope Road with hardly a side look and zoomed into Green Bay road. A left and a left and he was there, The familiar lannon-stone two story house looking just a little bit unkempt. Karen was looking at him from the second story bedroom.

Jacob overshot the drive, stopped and drove back into the driveway, facing out again. He ran out despite the old pain in his hip and hoped that the door was open. It was not. As his eyes began wandering for a likely hiding place for the key, Karen opened the door from the inside.

"Where is Mom?" he said breathlessly.

"Upstairs" replied the little one, older suddenly then her seven-going-on-eight.

Jacob went for the stairs like the 25 year old he was not and pulled himself mightily up with his left strong hand when his hip rebelled. His Miriam was in distress and he would not let her down. The door was open and the bed unmade and Miriam was by the bed on the carpet and it was all messy over her once-beautiful Marshall-Fields house coat. She was just done with another bout, and her hair was a mess and the sweat was pouring down her face.

"Gott-im-Himmel" he muttered, Jacob always reverted to his childhood mother-tongue when under severe stress. "How far apart are they?"

"Don’t know, they seem to come almost all the time. I am sure I'm gonna have the baby very soon." Miriam was regaining some color and confidence. Her father was always a rock of a man, unfailing in his love and support. What a poor substitute John turned out to be.

"Alright, Esther was calling Dr Berkovitz as I left. Let’s get you out of this coat and up on the bed." Jacob was alarmed but not frightened. In Treblinka he had been the right hand man of Doctor Menashko, and helped deliver women under the worst of circumstances. Jacob flashed back to the Camp, the filthy huts, the 4 tiered bunks, with half-dead inmates looking on as the unfortunate malnourished women gave birth to wretched human babies, destined for instant death if the Kapo found out. Some of the women died right away, some survived and hid the babies until the inevitable time that the newborn was snatched away, mewing like a lost cat. Jacob was not the Doctor but he had learned a thing or two. Now it was up to him again because his grand-baby was coming, ready or not.

Karen was at the door, all serious and adorable.

"Get me some towels, Karen" Jacob said gently. "If you know where the scissors are bring them too."  Karen turned and rushed to the bathroom just as Miriam was gripped in a spasm again. "Breath!" Jacob commanded as he threw back the covers. Jacob had never looked there since Miriam was 7 years old but he knew he now must. Miriam arched her back, little screams forcing their way past her lips and then bore down, and Jacob hastily pushed a couple of pillows under her head. Then the Labiae separated and a huge round head seemed to dilate the small structures beyond any imagination, there was no way it could pass through that tiny crevasse. The spasm relaxed and Miriam started heaving breaths again, like a drowning victim suddenly revived. Jacob wiped up the mess with the sheet and threw it aside.

"Here are the towels, Zeide" Karen said in a small voice "and Mommy keeps the scissors up high." She led him to the medicine chest in the bathroom and indeed there were surgical-like scissors there. Jacob grabbed the scissors and opened the hot water full on. Scalding water washed over his hands and scissors. It was time to get back to the delivery.

Jacob gave Karen the job of pushing the pillows under Miriam's head and concentrated on the job at hand. He wondered why the Fire Department or the Doctor or whoever were not there but a quick glance at his watch showed him he had only been there a few minutes. He hoped the head was not too large. He remembered a Paulina Wohcek, who had a Caesarean done because the head was too large despite the cut, she died with a horrible infection two days later and Dr, Menashko was powerless. Jacob was determined to make the cut deep and wide. Miriam quickened breathing alerted him from the instant musing and Jacob was ready. As soon as the crown distended the tortured flesh, flesh unrecognizable as anything resembling Sexual parts, when his daughter’s screams and breathing reached their greatest intensity, he slipped the scissors under the edge, along the dark-haired crown , and then CUT, the flesh surprising him with its toughness and tenacity. He expected it to pop with the first application of pressure, but of course those women were emaciated and wasted where this one was strong and robust. As soon as the flesh separated and bled profusely the head almost jumped forward an inch. "Push" he yelled at Miriam, "and it will come." "Raus" he hissed at the baby and out it came with a final burbling groan from Miriam.

"Alright stop pushing, move aside Jacob, I'm taking over" boomed a new voice. Dr Berkovitz gently pushed past Jacob who readily retreated and hastily wiped his hands on a towel. He joined Karen who looked up at him adoringly and held his daughter's sopping hand as Dr Berkovitz, surgical gloves on, pulled the baby, first down to release the shoulder, and then up. A lusty cry of a new born baby filled the room to capacity and Jacob finally broke down and cried as if his heart would break. Dr Berkovitz quickly put a clip on the umbilical cord, and placed the baby on Miriam’s belly. Outside the ambulance shut off the wailing siren. The Golds who lived across the street came out anxiously still in their housecoats and rushed over the lawn to the ambulance. Dr Berkovitz busied himself with the delivery of the placenta and presently it came out with a rich flow of blood and congealed matter. He examined it carefully, there were no tears. 

"Did you do the Episiotomy?" Dr Berkovitz addressed Jacob with wonder in his voice.  Jacob nodded dumbly, still holding on to his grand-daughter.

"Well, gee, I never... Dr. Berkovitz shook his heads "well you did a good job, but Miriam must go over to the Hospital now, with the baby, what is the Baby, anyway, let’s take a look."

 

 

Dr Berkovitz gently picked the baby who was already making sucking sounds and looked. "It's a boy, are you gonna have a circumcision or a Brith, never mind that, now let’s giddy up and GO. Where are those scissors, I better culture them too."

Miriam suddenly shook herself alert from the thrall she sank into as soon as the baby's shoulder was delivered. "No circumcision, and don’t let John near him."

Dr Berkovitz nodded, a pained expression crossing his features. The Glendale fire-department medics came up, and moved Miriam, sodden sheets and all onto the gurney. They tied her with the straps for the way down and Dr Berkovitz carried the baby wrapped up in new towels close to his chest. The baby was rooting, looking for the breast. He appeared robust and Dr Berkovitz had no fear for him. He ordered the Medics to start an IV, and had a bottle of Hartman solution bolused into Miriam’s system, who knows how much blood was lost into the sheets and the episiotomy that the crazy, brave old man had made. This was a big baby, and with powerful enough contractions the uterus could conceivably rupture and then God help the poor woman. The Medics loved their siren and soon everyone in the neighborhood knew that Mrs Fitzsimmons, whose husband had left her, just had a baby.

 

Eight days later a small gathering convened at the Glendale Beth Israel Synagogue. Dr. James Lipkin from Mount Sinai Hospital arrived with his instruments, and a few of the early morning regulars showed up to make up with Jacob the requisite community of 10. After the short ceremony they had some bagels, cream cheese and lox, but it was not a happy occasion. This Boy was fatherless and his mother, although Jewish by birth, had distanced herself from the community. Jacob Lifshitz stood in as the father and godfather, and vowed that this boy, named Alexander (why Alexander for goodness sake?) will know who he is, where he is going and who his real people are. Toby Fitzsimmons was there too and the grandfathers  acknowledged each other, distantly.

 

John came back when Alex was four months old. First there were bouquets of flowers, that Miriam threw with anger into the nearest basket. Then there were letters which Miriam did not read and angrily tossed the same way. But Karen did answer them, even though she did not understand what exactly he was saying in those letters. There was a blue box close to the school bus-stop, and she asked her daddy to come back. Miriam understood only later why her stock of stamps was being depleted so fast. John was persistent though, and the next bouquets stayed, and the letters were read.

One Sunday morning there was a knock on the door, which Miriam did not answer.

“Daddy, Daddy you're home!” Karen could not realize that it was six  months since she had seen him at home. "Mommy, daddy is here" she screamed shrilly.

Miriam came down the carpeted stairs, sedately, holding on to the baby who was sucking away contentedly on a pacifier. She looked at John, and at Karen who was so happy to see her Dad and was jumping all over him. He looked up beseeching, one eye buried in his daughter's wild hair, and one eye on her. He promised, and she should give him one more chance. After all, he was the father of her children. She turned to the living room and left the door open.

 

Karen had no idea what transpired between her parents but Dad was back in the house. There was one obvious change. Dad was home much earlier and after school he was almost always there to take her shopping, or ride the bicycle along the river, or play Monopoly during the long winter evenings. He was especially proud of her skating speed and stamina. It was back to uncle Henry and Aunt Jill, and her cousins Laura and Lee. In fact it seemed that as Alex was growing from an infant to a baby to a toddler they were seeing Grandpa Jacob and Grandma Esther less and less. Occasionally she would see her parents hugging and kissing as they did in the past and this made her very happy. She took good care of her baby brother and soon was a dependable baby-sitter. There was no more talk about another baby.

Karen reached puberty and adolescence without any of the histrionics associated with the transition, and became a serious young woman. She developed her skating abilities, rose in the State ranking, and became the under-16 short distance skating champion, and her coach, Kevin Kollen, began looking into the Olympic future. She liked the company of the volunteers of the Glendale fire-department, especially the paramedics, and learned from them as much as she could. The men especially could not resist teaching the beautiful teenager, and telling of their exploits in life-saving.  

 

Alex was  8 years old when Karen noticed he was huffing and puffing when trying to keep up with her up the hill where they watched the small rapids on the otherwise tame river. This was out of character because Alex was usually ahead of her, riding his bike in a sinusoid across the path and making figure-of eights around her, taunting her all the time. She propped up the old Sunbeam on the worn wood bench and waited for him. Arriving on the hilltop, he appeared a little pale and she could see his pulse race in his neck. He flopped  down  beside her and concentrated on his breathing. Karen knew from the CPR classes she was taking that rapid breathing meant either lack of oxygen, or insufficient circulation.

"Are you OK Alex?"

"Yeah I'M OK, just a little tired" Alex continued huffing. He settled down slowly.

"Is it alright if I take your pulse, just like I did when we played Doctor?" she asked.

Alex smirked "You are too big to play doctor, mom said I should not walk around with nothing on in the house ‘cause girls are not supposed to look at the boys."

"She is right you know, people need to have privacy, but all I want to do is count the pulse in your hand." Alex held out his hand and Karen placed her index and middle on the inside of the wrist and immediately felt it going rapidly under her fingertips. She looked at the old windup Tissot watch that Grandpa Jacob gave her for her twelfth birthday (it's my Bar Mitzva watch and I would like you to have it, he had said) and counted as the second hand swept around the face, She counted 142 beats in one minute, and she knew it was much too fast.

"Alex, when we get home we will go to mom and tell them that something is wrong, how long have you been feeling tired?" She imitated Dr Bacharach, he sometimes invited her when he was seeing kids in the County Clinic.

"I don’t know, a little while, and anyway, stop it, I'm alright, race you home, don’t get chicken on me down-hill, your breaks keep squealing." Alex left the bench, hopped on his BMX, and shot down hill. Karen followed more sedately, she fancied herself looking like the young women in the old BBC series on PBS, that’s why she liked the Sunbeams she found in a garage sale, they were antique as was the watch.

Back home, it was a glorious summer afternoon and Miriam was sitting in the swing on the patio-deck and reading Newsweek. Karen parked her bike in the garage and sat by her. Miriam put down the magazine and frowned at Karen. "Something bothering you my darling?" she asked.

"Mom, have you noticed Alex, he looks kinda tired and peaked?"

Miriam knitted her eyebrows "Well yes, he is a little more quiet than ususal and last Sunday he didn’t want to go to soccer, but those are normal ups and downs for a kid, why, do you see anything wrong?"

Karen would not be soothed "Mom, something is wrong, he is really out of breath, and he looks funny. Can you take him to Dr Bacharach?"

Miriam considered her impassioned daughter "You are turning into quite a little Doc, aren’t you, we don’t have one in the family, and at 16, we must think about college. All right, I'll call the office for an appointment.”

 

Alex had to be almost dragged into the East Side Doctor’s office. It was a typical Wisconsin office, low, unprepossessing outside, comfortable and inviting on the inside, with a huge aquarium that all children loved. The exam room was neatly arranged and Dr Bacharach was his usual cheery self.

"Hi Karen, you are more beautiful every day, it's positively a sin. Hello Mrs Fitzsimmons, do you know how good your daughter is with kids? Gee, Alex we haven’t seen you for a year at least. Your mom tells me you are a little tired and out of sorts."

Alex shot a venomous look at his older sister, "she is crazy, first she holds my hand then I have to go and get poked. No poking!" He hugged himself and looked defiantly at the doctor. Dr Bacharach smiled.

"No poking just yet, let's get the women-folk outta here and have a man-to-man talk." Karen and Miriam filed dutifully out of the exam room. Karen had watched Dr Bacharach's face as he had looked at Alex, he was concerned, no question about that. She went over to the aquarium and desultorily followed the tropical fish in their unending quest for food.

Dr Bacharach was way more serious when he came out of the exam room, he told the front desk to hold his calls and to send Mrs Fitzsimmons to his office in the back. Miriam was positively frightened.

"Mrs Fitzsimmons" he said without preamble, "I am concerned about Alex, and I do want to do some blood tests. I can either send you to have them done right now at St. Mary's, or I can take them, and call you tomorrow with the results. Please don’t ask me now what this can be because that is why I need the tests."

Miriam’s fear level rose some more, but she knew that doing things in the hospital would be impossible with Alex. He would scream and raise hell, even simple kindergarten shots were a disaster. "Let's do things here" she decided.

 

Alex was sulking all the way back. "I'm gonna tell Dad on you how you made me get a poke and for what, just ‘cause I didn’t feel like playing soccer on Sunday" he lapsed into silence, he suddenly looked terribly pale. John was on a business trip to Chicago and would come back very late. In fact he came back so late that Miriam decided not to tell him anything that night, but sleep did not come easily to her.

The phone rang at the Fitzsommons residence at 10 AM. Gloria at the Doctor’s office requested that they set up an appointment at noon and that both parents be present. Miriam knew  this was serious. She called up John at the office and told his secretary of this appointment. They met in the parking lot, and holding hands tightly they ascended the steps to the waiting room.

"Hi Mr Fitzsimmons, Hi Miriam, the doctor will be with you shortly." Gloria chirped and went back to the phones. Miriam noticed that nurse Beatrice avoided her eyes as she hurried from one exam room to the other. "You can go in now" called Gloria.

John followed Miriam to the small office in the back. The walls were papered light blue and pictures of various  aircraft were hanging on the wall. Dr Bacharach walked in with a sheaf of papers. He shook hands with John and Miriam and settled his big frame in the executive chair. He was dead serious. They were frightened.

"I have some difficult news, and it's difficult for me too, so please let me talk and then I will answer your questions. Is that OK?" they both nodded, waiting for the bombshell. "Alex has been ill for a fair while and this is typical. He has had some aches and pains, and some bruising that was a little excessive but you put that down to the usual boy antics, right?" More nods. "Well, all those are signs of his bone marrow, the part of his body that makes the blood components, failing to do its job." Dr Bacharach spread the sheaf in front of the bewildered parents. "This is a blood count that the automatic machine makes for us and it is very reliable." Miriam and John leaned forward to look at the meaningless rows of numbers, neatly arranged top to bottom, that were holding the doom of their child. "And this is a count we took from Alex at 3 years ago for his kindergarten physical. Look at the HB, it represents hemoglobin. It was twelve point five then, and it is only seven point two now. The WBC, which represents cells which fight infection were eight thousand three hundred. Now its only two point three thousand. Look at the PLT, that represents cells important in blood clotting. It was two hundred thousand, and now it is only forty eight thousand. Something is seriously wrong!”

"But what is wrong doctor, why is it that way?" Miriam quavered.

 

 

Dr Bacharach leaned forwards and met them eye to eye "I don’t know, but I know who would, and he is the best man in the world, and he works right here in Milwaukee. I called him up at the Medical College and he advised  me that he would see you anytime."

John was not convinced "Dr Bacharach, don’t you think that Chicago would be better, I mean, Children’s Memorial... he stopped as Dr Bacharach emphatically shook his head and reached for the big Nelson Textbook of Pediatrics. Karen had seen him browse that book previously, Dr Bacharach was never too shy to drag out the big book and look through it right in front of the patient. It was already marked and he opened it in front of the shaken parents. "See here, this is THE textbook of Pediatrics, and look who writes the chapter" they craned their necks "and see from where? right here in Milwaukee, if this man thinks that Alex would best be served elsewhere he will  be the first one to tell you. I want you to see Dr Kammitzer today or tomorrow because this cannot be put off. Do I have your promise you will take him?" Miriam assented immediately, John was a little more hesitant. This was typical of the city which is always described as 'Milwaukee? Oh, it's North of Chicago'. Even the natives feel that somehow some things are always bigger, or better, or more elegant, in the huge Metropolis to the south. Of course, there is nothing further from the truth, since Milwaukee is a city which lacks nothing, and compares favorably with Chicago in every aspect of quality of life, medical care included.

John did not think that Karen ought to come with them but she insisted and Miriam agreed "First, she is the one who noticed things, and second, she knows so many things that I am sure she could make sense of the Doctor Talk better than you and I." Karen sat in the back of the Olds wagon and played cards with Alex. Alex thought this was a grand day, no school, early June sunshine, and the poking all behind him. Karen was so bad at 21 that he beat her every time. It was not a long drive, Good Hope road east to the 43, then south on the freeway, off to Wisconsin Avenue, past the Marquette University, the Children’s hospital had been the same dingy block since 1926. The hospital had clearly outlived its facilities by the Eighties. The age and smell of the buildings were powerful deterrents to some of the more affluent citizens of the city. They parked close to the entrance and walked into the old foyer, small, uncomfortable, but prettily decorated with children’s art. Soon they were directed to the first floor, and seated in the waiting room. There were other kids there and the Fitzsimmons family stared with horror at the scrawny necks, the white faces, and the hairless scalps, and then John stood up, pale and angry.

"Let's go, this is the Cancer Ward, it’s a mistake, I knew we should have gone to Chicago." Miriam was just as frightened, and irresolute, Karen examined her father, he was irrational, and forceful. "ALEX" he almost shouted, Alex was already off to examine the whiteboard with markers, together with a black kid who was scrawling his name in red "We are going, Alex" he was very loud and Miriam rose to calm him. The door opened and a small man with penetrating eyes and economy of motion walked toward them. The receptionist, who had seen this kind of reaction before made a quick call to the man who could deal with a delicate situation. Dr Kammitzer was as good with people as he was with Bone Marrows.

"Hello there, I am Dr Kammitzer, you must be the Fitzsimmons family, and you must be Karen, Dr Bacharach told me I should look for an exceptional young woman and" he appraised her "he is right, as usual. Please come in." thus he disarmed the scowling John. Karen walked over to Alex and gently disengaged him from his new friend.

The exam room was small and stuffy, Dr Kammitzer had picked up a fresh-faced student who scribbled on her clipboard as the questions and answers came. Finally Dr Kammitzer said "Alex, you know I need to examine you and this room is very small, would you like Mom or Dad to stay with you?" Alex was very interested in the little poodle on the student’s stethoscope "I want Mom" he said and so Karen and John filed out dutifully.

It seemed like hours until the initial blood tests came back, but then the receptionist called them all to the Doctor’s office. John was back to scowling and Miriam was more frightened than ever. Dr Kammitzer surveyed them from behind his desk, hands on the sheaf of paper, in exactly the same attitude of somber seriousness as Dr Bacharach 24 hours earlier.

"First thing first, we must admit Alex to the hospital because his Platelet count is very low, and that may put him at risk for severe bleeding." Alex snapped his head up at that and started edging towards the door. Suddenly Karen could see a flame shaped spot in his right eye, this must be a bleeding, she reported to herself. She was closest to the door so she held Alex gently and gave him a brave kiss on his dear forehead. Her baby brother was sick, but this Doctor will surely cure him.

"Second, I think that Alex is suffering from Aplastic Anemia, which is an illness pretty rare in children, which means that his bone marrow has stopped making cells almost entirely, this is a very serious illness. I know you have a thousand questions and that’s OK, fire away!”

 

Miriam wanted to stay with Alex that night, and then every night. There were tests, and X rays, and transfusions, and counts. They all gave blood. Karen stayed overnight, she met the parents, the residents, the nurses, especially the nurses.  She learned a whole new vocabulary, and she took every opportunity to ask for more information. The tests came back and soon they were all at Dr Kammitzer’s office again. Karen asked him once about a very strange inscription that was riveted to his desk. She knew those characters, of course, they were the same as in Grandpa Jacob’s prayer book.

"That’s the Doctor’s Oath in Hebrew, as written by a great doctor, the Maimonedes, who lived in Spain a thousand years ago, it's as relevant today as it was then!" he told her. He liked this intense young girl who was so concerned about her baby brother, and anyway, she was the compatible donor, she was a partner in the therapeutic effort. And there was always that tribal kinship, understood but never expressed, with the Grandfather, who came at odd hours, played chess with the kid, and pulled out his Psalm book when the kid was asleep to read silently.

"I have some answers and a course of action to propose, and before I make any propositions, I wanted to say that you should feel free to seek any second or third opinion before we do anything." John and Miriam nodded, by now they knew that this was the best place for Alex, however outdated the facilities were, and they were not going anywhere else. "We did not find an etiology, that is a reason or an agent that would cause the Aplastic Anemia. That is commonly the case. On the other hand we can cure him with bone marrow donated by a family member and you are lucky because Karen here is an exact match and the perfect donor for him." John and Miriam turned their awed faces towards their eldest daughter, who actually beamed with pride. "This is a much harder process than you might think, but the available data shows that it affords the best chance for a complete cure."

"What do I need to do, Doctor?" That was Karen.

"With your parent’s permission, and only then, we will take some bone marrow from your hip bone, and give it to Alex."

"But are you going to take out a part of her bone, this must be a terrible operation" John was horrified again.

"No, no” Doctor Kammitzer explained patiently, “the bone marrow is not solid. It's really like a gel suspended inside our bones. All we do, under anaesthesia, is stick needles into the bone, and suck out with syringes. There is plenty left over and it renews itself, not that the procedure does not hurt, but usually it means a one night stay in the hospital.”

"And what about that terrible disease AIDS, doesn’t that come through those needles?" Miriam was concerned.

"We use needles that are single-use-only" Dr Kammitzer replied for the ten thousandth time. He and his whole generation of Hematologists were absolutely thunder-struck, mortified, by the carnage inflicted through their own hands on their Hemophilia patients, by the AIDS disease. Patients  they had literally raised from day one, using the best that science and industry could provide in Factor support, were dying off in agony by the hundreds, and there seemed to be nothing they could do beside more research and prayer. It was just like the middle ages and the Black Death, doctors  walking through the wards filled with young people they knew, and seeing them to their deaths. The more things changed, the more they remained the same. "We have learned that contaminated blood passes the disease around and since last year all blood donors are screened. But there is never any absolute assurance. In Milwaukee, we have one of the lowest occurrence of AIDS in the nation so I expect our blood supply to be OK"  Promises, promises, he thought wryly.

"Mom, dad, I want to do this, I talked with some other brothers and sisters who gave the bone marrow, and I can do it."

 

The donation of the bone marrow was the easiest part of all, so it turned out to be. The process was like entering a long and dark tunnel of misery with the hope of reaching the light at the end, and that light was murky at best. Long nights, high fevers, midnight doctor consults, days which were no different from nights, new residents rotating through the hellish place, cries of families who realized that their child was doomed, despite all the efforts, and the occasional farewell impromptu parties for those who had recovered and left the unit. The nurses were the backbone of the whole complicated procedure, and the attending physicians relied on them implicitly. Karen learned to love them and came to the decision that this should be her role in life, that of the highly skilled nurse. They told her that only a few years back the success rate had been much lower, and kids were getting better all the time. This was a goal worth fighting for, making sick kids better. She confided in Grandpa Jacob, who was very enthusiastic.

"Do you remember how you helped me deliver him?"  Karen nodded solemnly "so now he is almost your son, because his new blood will be yours!"

And so it turned out to be. Three weeks after the bone marrow transfusion, Dr Gupta, the resident for the month of August, triumphantly showed Karen a laboratory report.

"Do you know what this means?"  he crowed.  Karen looked through and read.

 

Karyotype report

 

Name: Fitzsimmons, Alexander

Date: August 15th 1985

Specimen: Blood - buffy coat

 

The specimen yielded 24 mitoses of which 15 were analyzed

The karyotype is 44XX in all mitoses

 

This a normal female karyotype

 

Signed

A.F. Bolton PhD

Head of department- Genetics

 

"I know, I know" Karen said ecstatically "that shows Alex has my blood now, if this was his, then it must read 44XY, I cured him, I cured him" she was almost jumping up and down. Dr Gupta was smiling widely, teeth bright against his dark Indian skin.

"That’s right, you did, although he still has a fair way to go, and now since you DID cure him you must go back to summer school and make up everything you were missing."

 

Alex was discharged with fanfare 15 days later. He was quiet, subdued, pale, but his counts were going up daily and he was getting stronger by the day. He was getting so many medications it was hard to count. Karen and Miriam cleaned up his room so that not a single bacteria could survive. He was back at the outpatient clinic three times a week initially and then less and less often. Then disaster struck.

Miriam allowed a select number of friends from school to visit at home. Andy was his best friend and washed his hands as instructed and never brought any food. He never told Miriam of the pimples that appeared on his belly and were spreading in crops up his chest. Only when Alex broke out with a storm of those pimples did the story come out. Varicella, chickenpox, had always been one of the enemies of patients with compromised immunity, and bone marrow recipients were THE most compromised. Dr Kammitzer was dumbfounded as Alex was brought through the back door, so as not to expose other kids, and was even more horrified to notice that Alex was breathing faster than usual.

 

Alex was admitted directly to the Pediatric Intensive Care Unit, and the virus spread through his organs like a wildfire. His skin was covered with them, lips and mouth and face. Medications were useless and Dr Kammitzer raged over the phone at the pharmaceutical company that put red tape and FDA approval above the need to try an experimental drug for Varicella. The lungs became whiter and whiter and the fever raged daily. Miriam and Karen and John and grandparents practically LIVED in the cramped family lounge. The virus overwhelmed the little boy and he lost contact with the surroundings. One night he deteriorated some more and they had to put a tube in his throat, and a respirator at his bedside. Dr Kammitzer hung like a shadow at the bed and blamed himself for hinting that some friends could come and visit. The  little body became a thing, infiltrated by tubes, collecting oxygen, blood, plasma, antibiotics through various tubes, and  yielding urine and blood tests and wires which registered endless data on the screen and lab reports. The Intensive Care crew were becoming dispirited.

Jacob knew he had to take Charge, because no one was prepared to say the obvious. He accosted Dr Kammitzer after hours, as the latter was making his rounds.

"Dr Kammitzer, I am Jacob Lifschitz, Alexander's Grandfather."

"Yes, I have noticed."

"Doctor, I delivered this boy eight years ago at home. I vont you to give me your honest opinion about his chances of coming out of here." Dr Kammitzer returned a mournful gaze at the old man "Don't spare the details."    

"The whole truth and nothing but the truth?" he countered, "and are the boy's parents in on it?"

"No, they are not, and they do not dare. But I have been through the death camps, and sometimes death is a relief" Jacob bored into the younger man's eyes.

"All right, I reviewed the literature concerning overwhelming chickenpox infection leading to respiratory failure, after Bone Marrow Transplant. No survivors. Now, what are you going to do with this information?" Jacob maintained his gaze, and his eyes misted over, his face contorted, and tears were running down the lined cheeks, small sobs escaped, Dr Kammitzer hastily pulled out a Kleenex from the service shelf but it was soon over. The tears were dammed and the resolute gaze came back.

"I vill talk to my daughter and son-in-law, talk to Karen, and my wife and Toby Fitzsimmons. Then I vill get them all to meet with you and make a truthful decision." He turned and walked away, shoulders bent. Dr Abe Kammitzer shook his head with wonder. Those old geezers were tougher than nails, it was so hard to tell a family that their child would die, especially after you had already pulled him back from the Jaws. 

It took Jacob two more days to make the family understand that Alex was already dead, even though the monitor showed some cardiac electrical activity. They gathered around his bed, Miriam and John and Karen, Jacob and Esther, Toby and  Jayne. Henry Wilkins, who ran the pastoral services, joined them silently, and prayed. Dr Harvey Sands, attending intensivist,  and Lauren Lowes, who was the charge nurse for the day, disengaged the wires one by one, and then turned off the monitor. They had already given Alex the Caloric test and the Anoxia test and they knew he would not react. Dr Kammiter placed his index on the respirator button, and turned it off. An eerie quiet descended on the little stuffy room, Miriam turned to her husband, buried her face in his shoulder and cried, silently.

"Yisgodal veyiskodash Shmeh raba" Abe Kammitzer’s head snapped up, it was years, no decades, since he had heard that tune, the Kaddish, and he thought he was so well assimilated, even his own children were not Jewish. "Be'olma divra kireutei Veyamlich malchutei Viyekarev Meshichei"  Jacob's voice was getting stronger, even those in the PICU who had avoided the scene were now drawn back by the ancient words. Dr Abe Kammitzer found himself saying Amen at the prompt, just like when he was a young boy in St Louis. Karen listened and her heart went out to her grandfather who had lost his grandson, She was much taller than him, and as she looked down she could see the tears streaming uninhibited, and the way he moved with the prayer. "Veimru Amen" and they all repeated Amen, Jew and Gentile, all equal before God in the face of death.

 

John insisted on a catholic service and burial in the Glendale cemetery, Miriam said nothing. Jacob and Esther made no objections.

Karen went back to skating, and threw herself into the training as never before, leaning into the curves and driving herself raw. She became State Champion at 18 and a serious contender for the nationals. But she knew her real destiny, it was her job to help other people with the misery of illness, and share the triumph of cure.

 

Karen's skating career ended when she collided with one of the male skaters who would not allow her to go past. Her right ankle twisted, then snapped, the powerful ligaments tearing a piece of bone off. That ankle never allowed her to recreate the same efforts, and although she continued to skate she dropped out of active competition.

Karen  could never figure out her religious affiliations so she avoided all religion and religious gatherings. She had another faith, the faith of the Healer.

   

 

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