'I became transformed as both a clinician and a person'

Pediatric oncologist takes readers inside Hadassah hospital with new memoir

American-born Elisha Waldman reflects on the unique challenges of treating sick kids in religiously and politically complex Jerusalem

Renee Ghert-Zand is the health reporter and a feature writer for The Times of Israel.

Dr. Elisha Waldman (Michael Lionstar)
Dr. Elisha Waldman (Michael Lionstar)

Enter any Israeli hospital on any given day, and you’ll see Israelis and Palestinians of all backgrounds and religions — staff and patients — coexisting and cooperating. It’s a microcosm of a broader hoped-for peace in the Middle East that most people outside the country are unaware of.

American-born physician Elisha Waldman experienced this reality while working at Hadassah Medical Center for seven years. Now, he introduces it to an American audience with his new memoir, “This Narrow Space: A Pediatric Oncologist, His Jewish, Muslim and Christian Patients, and a Hospital in Jerusalem.”

‘The Narrow Place’ by Elisha Waldman (Schocken)

Waldman takes readers onto Hadassah’s busy and (sometimes too) loud pediatric oncology ward, and particularly into the private spaces and conversations where doctors and nurses discuss treatment plans with severely ill young patients and their families. Tragically, sometimes there are no more medical options — on- or off-protocol — left to try.

This, of course, would be the work of a pediatric oncologist anywhere in the world. What sets “This Narrow Space” apart is that it presents the unique complexities of caring for sick children in Jerusalem, arguably the most religiously and politically charged city in the world.

People from every sector of Israeli and Palestinian societies ended up under Waldman’s care: Secular Jews, ultra-Orthodox Jews, settler Israelis, Palestinians citizens of Israel, and Palestinians from the West Bank and Gaza who temporarily entered Israel with permits given on humanitarian grounds.

Waldman’s memoir shows how the hospital atmosphere positively highlights the commonalities among all these groups.

“It’s about recognizing that there are certain values and strains of humanity that run through all of us, whether you are a Haredi Jew from Jerusalem or a secular Jew from Tel Aviv or a Palestinian coming in from Hebron,” he said.

Aerial view of Hadassah Hospital Ein Kerem, Jerusalem, March 17, 2014. (Yossi Zamir/Flash 90)

To a great extent, Waldman was forged in the Hadassah crucible. It was there that he learned more about himself, became a better physician, and also decided to specialize in pediatric palliative care.

“I became transformed as both a clinician and a person during my time there,” Waldman told The Times of Israel.

As a palliative care specialist, Waldman, who has had an abiding interest in spiritual matters, sits with families and kids making hard decisions.

“My job is to help understand who these people are, what is important to them, and to figure out how we align our medical care with that. It was something about that experience in working in such a crazy and out of context place for me in Jerusalem that really allowed me to sharpen those skills,” he said.

Dr. Elisha Waldman with medical clowns in Hadassah Medical Center’s pediatric oncology department, 2009. (YouTube screen shot)

Waldman, 46, no longer lives in Israel, and is currently associate chief of the division of pediatric palliative care at the Ann and Robert H. Lurie Children’s Hospital of Chicago.

The author said he was heartbroken to leave Israel for a position at Morgan Stanley Children’s Hospital at Columbia University Medical Center in New York in 2014, when it became clear that Hadassah did not intend to support his efforts to establish Israel’s first full pediatric palliative care service.

“I left with feelings similar to ones you feel with unrequited love. I didn’t get the response I was hoping for or thought I deserved, whether that is egotistical, or fairly deserved. I’ve come to terms that this was a necessary and smart move for my family, but I miss Israel every single day,” said Waldman, who is married and has a young son, with another baby on the way.

I left with feelings similar to ones you feel with unrequited love

Prior to his residencies in pediatrics and oncology at Mount Sinai Medical Center and Memorial Sloan Kettering Cancer Center in New York, Waldman lived in Israel while studying for his medical degree at the Sackler Faculty of Medicine at Tel Aviv University. He had also visited the country many times with his Conservative rabbi father, mother, and younger brother and sister while growing up in Connecticut. (His entire family now lives in Israel.)

A young Elisha Waldman (lef) and his brother in Israel on a family visit in 1979. (Courtesy)

However, Waldman’s aliya in 2007 and years as an attending physician at Hadassah gave him an entirely new perspective on what it’s like to be an Israeli doctor.

“It’s one thing to do your rotations in the hospital in medical school, when you are still trying to figure out how heart failure works and what medications to give for it, and another when you’re the attending physician actually managing a deathly ill child. You’re in a very different place trying to navigate that system,” he said.

As a young immigrant physician to Israel, Waldman was drafted to IDF service. He had just completed his officers training and was in charge of Hadassah’s pediatric oncology department for the month when Operation Cast Lead broke out in Gaza in December 2008. It was then that he wrote the essay that would eventually grow into “This Narrow Space.”

“A lot of things just emotionally came to a head for me in those couple of weeks in terms of my identity and the patients’ identity. This weird stew of the Israel issues mixing with the backdrop of really sick kids. I woke up at 2 a.m. in my apartment and just vomited out this essay onto paper of what it felt like to be working there at the middle of all that. I just needed to get it out of my soul,” Waldman said.

Dr. Elisha Waldman during his IDF service. (Courtesy)

A recurring theme in Waldman’s memoir is the influence local religious authorities have over their followers’ healthcare and end-of-life decisions.

“In the ideal world, communication between a patient’s rabbi and the medical team would be seamless, everyone working together to explore goals, hopes, and fears in order to come up with a plan that is both medically and religiously or culturally appropriate for a given family. But in reality that sort of relationship rarely materializes,” he wrote.

More than once in his memoir, Waldman expressed his astonishment and frustration when ultra-Orthodox Jewish and religious Muslim parents alike refused to let surgeons amputate their daughters’ life-threatening cancerous limbs because of disfigurement stigmas.

Going into it, Waldman assumed his biggest challenge would be dealing with the Palestinian population, and in particular not being sufficiently clued into the attendant political and cultural subtleties. It turned out that Jewish religious differences were the hardest nut to crack.

“I think it was maybe because I had more skin in the game when it came to this. It involved my own religious identity and my own sense of community… and waking up to the fact that there are a lot of sub-communities, and that not everyone takes a pluralistic approach to diversity,” Waldman said.

“It’s not to say that I was not invested in the Palestinian issue. I actually feel deeply invested as someone who made aliya [immigrated to Israel], and as a human being, but I think it was easier for me to look at that as something external to myself… The real puzzle was getting into the heads of the Haredim from Mea Shearim who pulled down even more of a veil between them and me [than the Palestinians did],” he said.

Parents and young cancer patients in the hemato-oncology department at Hadassah Ein Kerem march as they protest against Health Minister Yaakov Litzman and Hadassah Ein Kerem Medical Center CEO Zeev Rotstein in Jerusalem, June 7, 2017 (Yonatan Sindel/Flash90)

Waldman has followed from afar the recent Hadassah pediatric oncology department crisis. In March 2017 his former boss and mentor, department head Prof. Michael (Mickey) Weintraub, along with five other doctors and three interns, decided to resign over a hospital management decision to reorganize that they felt unable to accept on medical and logistical grounds.

“I feel that what Mickey created in that department was a really beautiful, special bubble. It was a place where staff and patients and families — despite the fact that they were all threatened by the worse illnesses you can imagine —  all felt safe and protected,” Waldman said.

“It seems to be me that the hospital leadership and Health Ministry were extremely short sighted and narrow minded, and cost the greater Jerusalem community an incredible asset,” he said.

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