As our experience on the ambulance continues, our learning curve has been less dramatic and we are starting to feel much more comfortable in our roles. As such, the days start to blend together, and by 5pm it can be difficult to remember the first case of the day. Initially we would always recount all the details of our day, full of excitement. However, as the novelty wears off, and most of our time is spent transporting elderly sick people (including countless pneumonia patients) and attending car accidents where nobody suffers severe injuries, it is only the truly exceptional cases that stick out.

On Tuesday I worked with Paul and we had a couple of interesting cases. First, we picked up a young girl from a street corner in the middle of a commercial district. The girl was tiny, and obviously had been living a rough life. As always, we donned our gloves and treated her with the same care that we give any patient. After dropping the girl off at the hospital, the driver informed us that the girl had just left a drug rehabilitation clinic and had not eaten for several days. This was not the first time I had worked with a drug patient. A few weeks ago we picked up an IV drug user who had fallen and hit his head. The patient was bleeding, so we took careful precautions. However, even with high-risk patients, we recognize the importance of completing our job functions. We take the philosophy of MDA very seriously, and treat all patients equally regardless of the patient's circumstances.

Later in the afternoon on Tuesday I had my first ambulance trip into the Old City. We were called to a predominately Arab elementary school in the Muslim quarter to treat a 10-year-old boy who had fallen. Actually driving into the Old City was quite a challenge. First we had to wait for a military escort to enter the gates, and then the driver had to navigate the fairly large ambulance through the tiny streets that were built centuries ago. I had never seen such amazing driving.

When we arrived at the school we found the boy lying patiently on a gym mat without any visible injuries as a large group of adults and children huddled around him. Everyone is always especially cautious in treating children, but the driver quickly discovered that this little boy was fine. Paul took the patient"s blood pressure using the tiny, child-size blood pressure cuff, but the patient clearly did not need to go to the hospital. We navigated through the large crowds of excited schoolchildren and then headed back to watch our driver perform another automotive miracle in turning the ambulance around.

This week I also had the opportunity to experience another aspect of MDA’s organizational system—the satellite office. To the best of my understanding, MDA keeps the majority of its ambulances at its headquarters on the western edge of town, but every day one ambulance is stationed at the Knesset (Israel’s parliament building) and another ambulance is stationed at a small office more toward the southern edge of the city. As a foreigner, I cannot go to the Knesset, but I was able to visit the satellite office, where we watched TV and waited for a call. This is how I spend the majority of my days—sitting around and waiting for a few hours and then experiencing a rush of exhilaration as we rush to a call, never knowing what to expect next.