I see our translator comes with a side of agenda. . .

Today our fascinating and varied array of patients included 7 cases of warts, 10 psoriasis outbreaks, three dry skin emergencies, 2 cases of acne, and one 27 year old male who is starting to go bald. About half of these were signed in as "urgent."

Luckily there are always a few cross cultural occurrences to help keep me interested. Watching the doctor contend with the veritable parade of languages, religions, and cultural norms that walk through the door on a given day is far more educational than the actual medical content.

A completely typical day may include several Bedouin patients, several secular Israelis, a few orthodox Jews, a handful of recent immigrants from Russia, Romania, Ethiopia, and West Africa, and one or two European tourists. It's dizzying.

A few select moments from today:

1. The clinic is very sensitive to modesty/privacy issues. All the doors are locked during patient visits and there is an additional screen or curtain in the corner so that the religious and Bedouin patients don't have to remove their clothes out in the open. Today, we got to experience ultimate (like award winning) modesty. An orthodox Jewish woman in an ankle length skirt came in with a psoriasis eruption on her heel and insisted on going behind the modesty screen while removing. . . her sock. Not even removing, just rolling it down over her heel.

I'm with her, no good can come of women wantonly exposing their ankles.

2. We've seen multiple Bedouin women over the past few days with severe dry skin. Today, the doctor explained to us that a few of the desert tribes have a tradition of bathing for a few hours a few times a day. Sure enough, when I asked a patient today how long she usually showers for, she answered, "the normal, two or three hours."

3. The doctor was speaking to a twentysomething secular looking woman through a Greek translator. He was considering accutane for her acne (which can harm a fetus) so he needed to know if she was sexually active and if there was any chance she might get pregnant. He asked the translator to ask her if she was at any risk of getting pregnant. Without asking the patient, the translator immediately replied "no." The doctor repeated the question and asked the translator to please ask the patient. The translator refused, "It's not relevent, doctor. She's not married."

(A friend of mine had the exact same experience with her doctor. He was thinking of prescribing her an antibiotic that is harmful in pregnancy and asked her only "are you married or engaged?" before prescribing the drug).

4. A young Bedouin woman with severe warts on her hand came in to have the warts burned off. Her hands were hurting her after the procedure so the doctor asked her father if there was anyone who could help her around the house so that she wouldn't have to cook or wash dishes that evening. Her father responded "no, there is no one to help her. She has only five brothers at home."

(One of my classmates, a secular Arab-Israeli, stepped in and tried convince the father to make one of the brothers help out around the house, at least for that evening. The girl, who hadn't understood the (Hebrew) conversation up to that point, nearly fell off her chair laughing at the the thought of one of the men helping out with the housework. She honestly couldn't fathom.)

5. The camels are grazing!! There are camels strewn literally all over the city. And herds of sheep with sheperds following them on donkeys. It's like Israel is trying to be extra extra middle eastern for my last few weeks here.