A(nother) Day At The Hospital

The Boy has mild cerebral palsy complicated by a seizure disorder. We were delighted to find an excellent neurologist in Jerusalem, Itai Berger at Hadassah Mount Scopus, who determined that the medication the Boy had been taking these many years wasn't being metabolized by his body, hence the seizures kept re-occuring.

We started a regime of new, different medication and it has made a huge difference: a kid less drugged, more alert, with more energy, more focus on studies and better social skills. He has been seizure-free for quite some time, so in keeping with the special ed school's recommendation to foster independence, we started letting him walk to and from school. It's really four long blocks, but they are doozies! He has to cross Derech Hebron, Derech Bet Lechem, the Railroad Road and Emek Refaim -- all of them crowded with impaitient drivers who all too often are talking (illegally) on their cell phones, yelling at other drivers, shushing their kids and generally divided-attention-challenged in one way or another.

Because his Mom is paranoid, I walked with him to school the first week. "Iiiiiimmmmaaaa," he complained (he is 17, after all), "I can walk by myself." And to prove it, he took off on those long legs of his, leaving his mother about a block to two blocks behind. Rather than chase him to school, I gave in with poor grace and admitted that at 17 he can probably walk to school ALONE but I wanted him to call me when he got to school so I would know he arrived safely. There was grumbling about that, but he gave in rather than have me shadow him every morning.

I'm concerned about his crossing the streets NOT because he doesn't know how--as a kid with vision impairment and seizures, he's been getting Orientation and Mobility training since 1st grade. He knows how to get around better than most adults. I'm worried about the crazies--the guy who decides there's no cop around, so it's safe to blow through the red light (killing the pedestrian he didn't see); the guy who decides to drive too fast because he's late and takes the corner without slowing (and kills the pedestrian in the crosswalk he wasn't expecting and didn't see until too late); the driver so distracted by her kids acting up in the back seat while talking to her mother on the cellphone that she hits the pedestrian in the crosswalk that she was too distracted to notice (slicha--taoot, doesn't do it, motek).

But this layer of concern is trumped at all times by the fear that the Boy will simply have a seizure on the way to school and end up falling in the street and being run over by some idiot on a cellphone.

And today he had that seizure.

I got a phone call from him just after he crossed Emek Refaim. "Ima, I don't feel so good," which is Boyspeak for "I'm starting to have a seizure."

"Where are you?!" I asked. He told me he had just crossed Emek Refaim. "Stay there!" I told him. "Sit down and don't move. I'm coming!"

Yeah, I'm coming--but after running to the car and getting into traffic (Jerusalem's answer to the Gordian Knot), I realized I probably would have reached him faster by simply running downhill the four blocks it took to get there. As it was, with it's maze of one-way streets and impassible traffic, it took me at least 15 minutes to get reach the road adjacent to Tal Bagels, where my son was lying unconscious surrounded by a crowd of concerned Israelis (G-d bless them!).

One man had searched Josh's pockets and found the keychain with our medical tag on it, and had already called Yossi (the only one of us who ALWAYS has his phone turned on) as well as an ambulance; another woman had helped take off the backpack and laid it down for the Boy to use as a pillow. When I got there and stumbled around in bad Hebrew, they were quick to assure me he had not fallen and not injured his head--they had made him lie down. A young guy with long hair ran across the street and commandeered a water bottle from Aroma so the Boy could drink.

My Hebrew was so totally absent from my panicked synapses at this point that when I parked the car at Aroma and tried to cross the street, I resorted to English: the ambulance is there, the road is blocked and some idiot decides to drive AROUND the ambulance into the oncoming traffic because, well, because it's Israel and he's in a hurry to get somewhere.

I was in the process of crossing the street to reach my kid and had NO patience. "STOP!!" I yelled in my loudest, angriest voice at the driver, and raised my hand as if to slam the sidepanel of his vehicle to indicate I expected the right-of-way. He was so astonished, and I looked so angry, that he simply slammed on his brakes and actually s t o p p e d. I appeared to have gotten the concept across without Hebrew....

The seizure was the worst I've ever seen: total loss of consciousness coupled with convulsions, which he has never had before. Prior seizures have all been what the doctors call "absence seizures" and usually manifest as a loss of focus, coupled with clamminess, sometimes temporary loss of vision, sometimes nausea and a need to sleep for hours (post-ictal state). Never convulsions. Never a seizure that lasts upwards of ten minutes (the usual time is less than 2 minutes).

The ambulance took us to Sha'arei Tzedek, a hospital I have heard of but never seen. As hospitals go, it was fabulous: quick registration near the ER, compassionate staff but efficient and good at keeping family informed and keeping an eye on the Boy. He was hooked up to a monitor for a few hours until they were sure he was all right, then moved to another berth. The ER doctor called our neurologist and got tests (all normal, surprisingly) and basically told me that "no one knows exactly what causes seizures--his blood tests are all normal, the meds should be fine, but we're going to increase the dosage in light of this seizure."

The ride to Sha'arei Tzedek highlighted one of the downsides of Israeli society. This is a country where people will cut in line, so Israelis jealously guard their places in line--often to absurdity. Any place where there is a line, newcomers check to see who is ahead of them, what number they have, and anyone who tries to cut runs the risk of lynching at the hands of the mob already in line.

Unfortunately, this line-obsession carries over into the traffic pattern. The easiest way to survive Israeli traffic is (1) don't be in a hurry and (2) let the other guy go first. Unfortunately, very few Israelis abide by these simple rules, and seldom give way to other vehicles.

This morning, the main road out of Katamonim was jammed with cars trying to make it to one of two major arterials to the west. This road is one way in each direction, with a raised concrete sidewalk-like barrier in the middle. The ambulance is trying to get through, lights on and siren blaring and NO ONE PULLS OVER. The ambulance ends up driving down the center of the road, wheels on each side of the concrete divider, in order to pass the clogged traffic.

I have a message for all of you Road Pigs on Golumb this morning: the ambulance driver wasn't running Code Three because the MDA crew was late for coffee! He was running Code Three because THAT WAS MY KID CONVULSING IN THE BACK OF THE AMBULANCE!!

PULL OVER NEXT TIME YOU SEE AN AMBULANCE!!!!!!

After hours at the hospital recovering, the Boy was sent home and slept the rest of the afternoon away, and is now up and hungry, so I am reassured that he is back to normal.

I'm not back to normal. I wonder if I can ever let him walk out the door again. I worried before about his safety and now the reassuring results of new medication are no longer a panacea against that worry. My fear of a seizure on the way to school was realized this morning. Thank G-d people were there to help him; thank G-d it wasn't in front of a bus but after crossing the street....but what about next time?

*photo credit courtesy of Canadian Magen David Adom