A Mobile MRI

by Brian on January 25, 2012

in Health

The mobile MRI truck in Beer Sheva

Following the unexpected clean bill of health I received from my “shocking” EMG test a few weeks ago, the search for the cause (and cure) of my sciatica continued last week as I underwent an MRI (magnetic resonance imaging) test. My doctor’s suspicion is that I have a problem on the L5 disc of my spine (whatever that means) and only an MRI can determine conclusively the next course of action.

Of course, scheduling an MRI through an Israeli HMO at any time in, say, the same calendar year is a task that even a young David would defer to Goliath. Hadassah Hospital in Jerusalem would be glad to book me an appointment, they told me…for April 17 at 4:00 AM.

My crafty wife, however, has learned – through unfortunate experience (securing a doctor to look at our daughter’s knee) – how to work the system and found an innovative solution: I would do my MRI in Beer Sheva at the “mobile MRI.”

Apparently, there is a trailer truck outfitted with an MRI machine that travels around the southern part of the country, parking itself for a week at a time in Beer Sheva, Dimona and Eilat. They had an opening – just one week away from the day we called – at an entirely reasonable time (1:00 PM) rather than in the middle of the night. We booked it and I psyched myself up for a pleasant drive into the metropolis of the desert.

To be sure, the MRI-on-wheels is a fully functioning piece of equipment. I can’t say as much for the nurse who needled my arm to open the infusion port that would pump radioactive “contrast” dye into my veins during the procedure. I had a feeling she wasn’t the most experienced nurse in the Negev as she repeatedly tapped my veins searching for the best one.

When I got to the MRI machine and lay down on the table, the doctor quietly scolded the nurse before turning to me to say that they’d have to open a new vein in my other arm (“just to be sure,” he assured me).

As for the MRI itself, if you’ve never had one, it’s an entirely alien experience. You place your head into a secure brace, don noise-canceling headphones and then lie perfectly still on your back for, in my case, about 25 minutes. Nothing spins on the MRI (unlike a CT scan) but there are a variety of noises – whirs and clicks and clunks – as the machine uses large magnets to look inside the nuclei of my atoms.

I passed the time by trying to match the sounds with intros to songs. One rhythmic beat sounded deceptively like the Beatles’ “Getting Better All the Time”; another clearly had the low-tech industrial warble of a Brian Eno solo composition; a third reminded me of the Steve Reich piece “Different Trains,” which played in Jerusalem last year.

I was in and out in just over an hour – perhaps because this was a “single task” facility, the mobile MRI staff were highly efficient. I was back in Jerusalem in time for a late lunch.

Now that the MRI was taken care of, I called up my HMO to schedule a follow up appointment with the back specialist. Yes, they would be glad to reserve me a slot with the doc. He has time on May 28. At least it was in the same calendar year.

Maybe I should see a back specialist in Beer Sheva too.

I first recounted my MRI woes on Israelity.

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Wine and chocolate at Tishbi

I’m a big fan of wine tastings. And an even bigger fan of chocolate. So when I had the opportunity to visit the new Tishbi tasting center, which combines both wine and gourmet imported French chocolate, my interest was piqued. Moreover, my palette was proud of yet another Israeli innovation, not so much hi-tech this time, but palpably pleasing nevertheless.

The Tishbi winery has been around since 1984 and is run by the family of the same name, which is committed to keeping it small and boutique. Winemaker Golan Tishbi was the one to come up with the idea of mixing wine and chocolate. The new tasting center, which was opened earlier this year, has been a word-of-mouth success, bringing in more than 40,000 visitors so far.

Tishbi takes its wine and chocolate seriously. Once in the tasting room, you settle into a standing station around a wooden bar. In front of you are three glasses and a rectangular box with six pieces of chocolate. Each chocolate is paired with a specific wine to bring out the flavors in both.

The glasses are of different sizes: the larger the glass, the more of the wine’s vapors enter your smell receptors, changing the overall sensory experience. I didn’t notice it so much, but I’m sure the late Israeli dean of wines Daniel Rogov would have.

For each chocolate, Tishbi instructed us to break off a piece and let it rest on our tongues. Taste it, feel it, let it melt, he beseeched us. It was hard not to bite, but then I was never very good with lollipops either. Once the tongue is thoroughly coated with chocolate, you drink in the wine. Let it float over the chocolate, Tishbi implied.

We then had a choice: let the wine carry the chocolate down, like a wet pill, or take them in one after another.

After a few moments of contemplation, it was on to the next wine and chocolate pairing. We learned the difference between “Manjari” chocolate from Madagascar and the Caribbean “Caraibe,” as well as the percent of cocoa inside (up to 85%, as decadent as they come).

At NIS 30 (less than $10) for a 45-minute gastronomic and oenological indulgence, it’s worth the gas to huff it up to Haifa (Tishbi is on the way, in the picturesque village of Binyamina). And if you need to chill out afterward and let the wine settle, Tishbi has a nice dairy restaurant right next door. But go for the apple pie – enough chocolate for one day!

There’s more about Tishbi and other delights in Israel’s Carmel region in this article I wrote for Israel21c.

I first wrote about this yummy combination on Israelity.

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Pacha Sleeping Mama

by Brian on January 11, 2012

in In the News

The Pachamama Alliance is a worldwide organization that aims to raise awareness of the environmental dangers facing planet Earth – from catastrophic climate change to the mass extinction of species.

The Israeli arm of Pachamama has been schlepping the organization’s five-hour core “Awakening the Dreamer, Changing the Dream” symposium around the country. Friends of ours in Jerusalem hosted about 30 people in their home last week to participate in the seminar.

A Pachamama workshop consists of a series of very professional 5-10 minute videos followed by small group discussions. There are activities (writing down vision statements, mini-meditations, calls to action) and larger group sharing.

The event is divided into two sections: the problems are spelled out before lunch, with what we can do personally to make a difference described after the meal.

The videos in the first half are quite disturbing and graphic, although if you follow the news, much of the data will be familiar (an example factoid: “if you have food in a refrigerator, clothes in your closet, a bed to sleep in, and a roof over your head, you’re better off than 75% of the people on the planet”).

After a barrage of 5-6 of these depressing films, I told the group that I felt quite useless; how could I as an individual possibly affect any kind of change when faced with an unquenchable demand on our rapidly reducing natural resources? Our facilitator said I should hold those thoughts until after part two; that there was indeed hope.

I unfortunately never got that far. After a healthy meal of lentil soup and fresh bread, I promptly fell asleep on the couch. While my wife sitting next to me was energetically creating a matrix of personal skills matched with possible responses, my head lolled in slumber, occasionally awakening to realize the other participants were being mutually empowered, before slipping back into dozy denial.

I vaguely heard the group leader asking my wife if she could wake me up for the final circle and her defending my right to nap. I rose anyway and regarded a very different group than the one I had left behind.

I feel kind of like the blue-skinned Na’vi in the movie Avatar about ¾ of the way into the film, when their world is being pulverized by the evil Earth army and there seems to be no way out. I came to the workshop to understand how I could make a difference. I left feeling depressed and drowsy, having missed the uplifting finale.

The good news: this will certainly not be the last Pachamama symposium scheduled in Israel and I’ll hopefully have the opportunity to attend another one. But next time, I’ll try to sleep during the first half.

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A Shocking Test of Nerves

by Brian on January 5, 2012

in Health

NCV shock therapy

I’m not sure what was worse – the over-sized needles stuck into my leg or the electric shocks.

Some background: about six months ago, I developed pain and numbness in my right leg. At first I tried to ignore it, imagining it just some strange runner’s pain, but when it didn’t go away, I stopped my exercise routine and went to my family doctor. He referred me to physical therapy which, when after three months of treatment, nothing helped, referred me to an orthopedist, who in turn referred me to a test called an EMG.

EMG stands for an “electromyogram”; it’s designed to detect abnormal muscle electrical activity. The orthopedist didn’t want to go forward on something major – surgery, cortisone injections – until he ruled out some sort of nerve damage.

An EMG is either a very popular test or they don’t conduct it very often; I had to wait a painful three months for the test which I finally did this morning.

How do they detect that abnormal muscle electrical activity? By sticking needles in the affected area and asking you to push against the doctor’s hand or the table as hard as you can. A machine next to the table translates your efforts into the noise of some alternative universe ultrasound (is my leg having a baby?) The pushing itself isn’t so bad but, dang, that needle felt bigger than the ones they use in acupuncture or to take blood.

For good measure, the orthopedist had also recommended another test call an NCV, for nerve conduction velocity. For this one, they attach metal conductors to your leg and feet and pump a jolt of electricity into the nerve. The first ones were OK; it felt like a strong static electricity shock, not much worse than rubbing a balloon on your head. But the electricity got progressively stronger. My leg jumped and I cried out.

The nurse told me to clench my fist as tight as I could. “Is this part of the test,” I asked. “No,” she replied. “It will take your attention away from the pain.” Super.

“Just three more,” the unsmiling, entirely uncommunicative doctor said.

And then it was over. There appeared to be blood spots on my leg, although on closer inspection, they turned out to be dots of magic marker ink.

“Wait outside while I write up the results,” the doctor barked, in what to him was probably his gentlest voice.

The whole process took less than a half an hour. As I walked out of the hospital and towards the light rail to head home, I opened the envelope with the conclusions that might make or break my case. Everything was entirely fine, the paper said; they’d found nothing.

While that’s normally the kind of answer you’d like to hear, for me it means more tests, more prodding and poking on the way to finding a treatment. My orthopedist said I will be able to run again. I just didn’t realize what he meant was running from doctor to doctor. Shocking, but true, so to speak.

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Maccabee t-shirt on sale from Australian website

Hanukah is probably the most confounding holiday on the Jewish calendar. If we move beyond the toys and the gelt of 20th century Christmas catch-up, the story itself has been interpreted in so many ways that it’s difficult to get a lock on the pshat (the simplest understanding).

For what is Hanukah? Is it the tale of a miraculous jug of oil that lasted for eight days, which today is commemorated in our lighting the candles on the hanukiah (the Hanukah menorah)? Or is it an historical account of a great military victory reestablishing, however briefly, Jewish sovereignty in our ancient land?

The answer is both…and neither.

It was “parent’s night” at the mechina (the pre-army seminary) where our daughter is spending a year before being drafted; a year of studying, volunteering and learning to get along with a group of forty other 18-year-olds (I wrote about it here). Part of the evening included a parent-child activity where we read selections from the first and second books of Maccabees, the two primary Biblical-era texts that refer to Hanukah (but which did not make it into the Hebrew canon).

The books present very different messages from the holiday. In First Maccabees, written about 40 years after the event itself by someone who presumably participated in one way or another, there is no mention of that universally known jug of oil at all; it’s all about the rebellion against the idolatrous Greeks and their assimilated Hellenistic Jewish wannabes. The second book, written 100 years after the first, downplays the military success and introduces the oil with an emphasis on God and miracles.

Historically, the attempt by the rabbis of the Talmud to sideline the fighting narrative makes sense, explained the head of our daughter’s mechina. There was at the time both a struggle between the rabbinic and priestly leaders for ascendency (the Maccabees were priests), and a desire to caution against military hubris (while the Maccabean revolt was successful, the next Jewish rebellions led to both the destruction of the Temple and the expulsion of the Jews from most of the land of Israel, definitely not events to emulate).

Seemingly ignoring the historical post-rebellion fall out, modern Zionists have eagerly adopted the holiday as emblematic of the brave fighters who liberated the land in our days. Whether that represents a miracle depends on one’s political and religious orientation. But there is no lack of Maccabean symbolism: many of our sport teams are named Maccabi and, in a striking irony, so is the Israeli version of that greatest representation of Greek culture the Olympics (dubbed the Maccabiah Games).

But there’s a darker side to the Hasmonean era military victory that tends to be whitewashed. The Maccabees were religious extremists; their goal was to rid the country of not only its Greek overloads but to compel the overwhelmingly secular Jewish population to adopt more stringent religious practices. Anshel Pfeffer, in this weekend’s Haaretz cites the late Christopher Hitchens as referring to the Maccabees as “bloodthirsty religious fundamentalists.”

Clearly over the top, but that interpretation seems chillingly appropriate this Hanukah as modern day extremists are once again bent on imposing their rigid agenda on the wider population. Open any Israeli newspaper in the last two weeks and it’s all over the front page:  – from coerced separation between men and women on buses and sidewalks, to the removal of women’s images on outdoor advertising in Jerusalem, to the truly horrendous verbal and spitting attacks on an eight-year-old girl for “lack of modesty” revealed during a weekend TV news show. And don’t even get me started about what’s going on with the “price tag” burning of mosques, unprovoked uprooting of Palestinian olive trees, and now even Jewish attacks on Israeli army bases.

Is this what the pioneers intended when they adopted the symbol of the Maccabees as their own?

Perhaps what we need today is to look at the story truthfully and learn from it with eyes wide open. To quote from Spiderman, “with great power comes great responsibility.” Religious power without accountability, without compassion and tolerance, necessarily leads to corruption (as happened, by the way, to the original Maccabees once they assumed the throne in ancient Judea).

The time has come to meld the two books of the Maccabees. Let us focus on light – the key symbol from the second book – as a metaphor for clarity; for the kind of clear thinking that can temper the violence of the first book. It’s as critical today as it was then. That would be a true Hanukah miracle for our times.

I ranted yesterday about Hanukah on Israelity.

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Radio Free Nachlaot Celebrates its Second Birthday

December 21, 2011

Jerusalem’s Radio Free Nachlaot turned two this month. The Internet-only radio station, whose slogan is that it broadcasts from “an undisclosed location somewhere deep in the heart of Nachlaot” plays a mix of Grateful Dead (and Dead-inspired) music, mixed with Shlomo Carlebach and Torah talks “24/6” (the station rests on Shabbat). Except on Wednesday nights, [...]

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Introducing iAccomplish – My First iPhone and iPad App. It Will Help You Feel Better!

December 15, 2011

I am very excited to share with you my first iPhone and iPad app. It’s called iAccomplish and it addresses that sense you can get at the end of the day when you’ve been working so hard but you feel like you’ve accomplished nothing. iAccomplish lets you write down everything you do during the day, [...]

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Emigrating Israelis – Point/Counterpoint

December 8, 2011

The discussion of Israelis overseas was a topic that just wouldn’t go away this past week. First I wrote on the Israelity blog about the video campaign “guilting” expats to come home. Then, as my colleague David Brinn added, the videos were pulled by none other than the prime minister himself. Now there is a [...]

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An Encounter in Beit Jalla

November 30, 2011

The last time I even thought about Beit Jalla, it was when rockets were being fired from that Palestinian village towards the southern Jerusalem neighborhood of Gilo. Israeli helicopter gunships would regularly fly over our home on their way to fire at terrorist targets. I would wake up at night afraid – that is if [...]

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FOMO at the Dead Sea

November 22, 2011

When I was ten, my parents planned a trip for the family to Disneyland. But a few days before we were set to leave, my father got sick – it was a cold or a flu, nothing serious, but still, the trip was cancelled. I was devastated and, since then, I have tried to never [...]

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