His late mother was an illiterate housewife and his father a simple farmer and construction worker who never got beyond fourth grade. Nevertheless, Dr. Aziz Darawshe’s 11 younger siblings include three physicians, a dentist, an engineer and five sisters who attended university.
There goes the theory that to get anywhere in life, one has to have well-educated and well-off parents...
But Darawshe – the impressive new director of the emergency department at Hadassah University Medical Center in Jerusalem’s Ein Kerem, and chairman of the Israel Society for Urgent Medicine – did have an advantage despite his disadvantages.
His father, now 83, decided even before Darawshe was born that his child would be a doctor and constantly directed him towards that target, even though residents in the village used to laugh at him when he revealed this dream.
Three months ago, the 57-year-old cardiologist, internal medicine specialist and emergency medicine expert replaced Prof.
Ya’acov Assaf who retired after 18 years in the position, beating other candidates competing in a Hadassah tender. Darawshe earned an excellent reputation since 1994 as chairman of emergency medicine at Emek Hospital in Afula.
A self-declared secular Muslim, Darawshe was born in Iksal, near Mount Tabor and Nazareth, and with his wife Mona – a mathematics teacher – he still lives in the village.
As soon as the youngest of their four sons finishes sixth grade they hope to rent a place in Jerusalem. Meanwhile, during the weeks Aziz sleeps at the Hebrew University Medical Faculty dorm near the hospital, feeling like a student again, and goes home for the weekend.
His eldest son, 27, has completed his medical degree in Jerusalem and is learning neurosurgery in Beersheba, while his second one is studying in Germany.
“I studied medicine at the University of Sofia in Bulgaria and earned my degree in 1981,” Darawshe told The Jerusalem Post in a recent interview in his spacious office which he has decorated with family photographs.
Asked about the Hippocratic oath he swore at graduation, he said he would have been happy to have sworn Maimonides’ oath if he had studied medicine here. He said he also admired Ibn Sina (Avicenna), a highly respected Muslim physician who wrote many a canon of medicine and many other treatises a millennium ago.
After graduation in Sofia, Darawshe returned to Israel to intern at Ashkelon’s Barzilai Medical Center and then, in 1989, moved to Emek. He also managed to complete a master’s degree from Ben-Gurion University of the Negev in health management systems that he earned at the Rabin Medical Center-Beilinson Campus in Petah Tikva. He has been an honorary member of the American College of Emergency Physicians since 2011 and has published around two dozen articles on emergency medicine in leading international journals.
“I was a senior cardiologist 20 years ago at Emek Medical Center when it was suggested to me that I move into emergency medicine,” he recalls. “The field always interested me, especially in treating urgent cardiac patients.”
Although he felt absolutely at home at the Afula hospital, when he was offered the job of department head in Jerusalem, he “didn’t hesitate for a moment. Hadassah is one of the best hospitals in the world.” He was offered positions in other countries, but he would never dream of leaving Israel to work abroad.
“I could have stayed in Afula, as Emek is in my heart. But it was a challenge to come to Jerusalem,” he said. The fact that it is owned by the Hadassah Women’s Zionist Organization of America did not cause him to hesitate either. “I am an Arab, a Palestinian and a citizen of Israel on all counts,” he declared.
“All my Arab friends encouraged me to advance to the new position in Jerusalem, although some felt it would leave a hole at Emek. There is a temporary replacement, but a new Emek department head will certainly be chosen.”
Although he is only now finding his way more easily through the labyrinthian Ein Kerem campus, including the magnificent $360 million Sarah Wetsman Davidson Hospital Tower, he is not yet used to the cooler climate of Jerusalem.
“Another difference is the case mix in the two hospitals. In Emek, we had fewer beds, but 140,000 annual visits to the emergency room. In Jerusalem, there about half as many emergency visits, but the patients generally are sicker, because a tertiary medical center like this accepts the most difficult cases.”
As chairman of the society representing all urgent care specialists, he is well familiar with departments in all of the country’s hospitals.
DARAWSHE IS is very concerned about the shortage of physicians and nurses. “I don’t think medical school candidates should need to have such high grades on their psychometric exams. They could become excellent doctors even if they had lower marks. So many doctors have left their jobs to go to better-paying professions or left the country to earn more. We have an excellent level of medicine, but young doctors have to work very hard, too many duty hours, with too little time for their family.”
The emergency medicine head doesn’t like private medicine. “It’s kosher, but it stinks. I am for keeping doctors in the hospitals for much of the day rather than than seeing them go in mid-afternoon to private clinics,” he continued.
Thus private medical services (known as Sharap) available at certain public hospitals including Hadassah (though not at Emek, owned by Clalit Health Services) are an answer, although Darawshe is somewhat wary, saying such a system not allows a patient to pick his own physician but can be abused and lead to service queue-jumping.
“In principle, medical professionals shouldn’t receive money directly from patients, but I have to live with the Sharap arrangement [in which the hospital collects fees and shares them with senior doctors].”
He is most discouraged by the shortage of hospital beds in the country. For the person in charge of emergency rooms it is always frustrating when sick people are stuck there instead of moving on to the relevant department.
“I call them ‘boarding patients,’” he said.
“Departments have even been closed, so there are fewer beds, even though the Health and Finance Ministries have increased the number of funded beds by a few hundred. That’s good, but it’s too little and too late. I use so much energy and nerves to find space for my patients. Magen David Adom ambulance personnel even have to wait at emergency departments to see if there is room for them [the patients].”
Darawshe is also frustrated by the large number of road accidents that kill nearly 350 people a year and injure many more.
He concedes that Arabs inside Israel and in the territories too often drive wildly. Education and enforcement are the answer. The many preventible home-accident victims are also painful for him to watch – and treat. Emergency departments must constantly be on alert for victims of family violence – especially women, children and the elderly. Awareness of the medical staff regarding this issue must be increased through seminars, he said.
In addition, Darawshe wants privacy for patients increased in emergency rooms throughout the country. Referring to the annual winter crisis of sick children and older adults in emergency departments, he urges that everyone aged six months and over get their flu shots.
He is well aware of the Hadassah Medical Organization’s current financial crisis that will require severe cuts to fix.
“I had heard about it, but feel it more once I came here. I believe that medicine must go hand-in-hand with economics when deciding what to do, but it should not go beyond that. Overdiagnosis, overmanagement and overtreatment are also not good. I would love to have more doctors in the department. I hope the economic problems will pass as soon as possible. ” AN UNUSUAL characteristic one discovers in Darawshe is his drive to understand and get to know his patients. Besides Arabic, Hebrew, English and the Bulgarian he learned at medical school, he also speaks “a bissele Yiddish,” Russian, Spanish and German – learned either in courses or from his conversations with his colleagues and patients.
“Last October, I was invited to an event at Beit Hanassi [President’s Residence] in honor of Bulgarians, and I was able to speak to them,” he said. “I sometimes make errors in Arabic, and I don’t feel bad. But if I make a mistake in Hebrew, I feel terrible. I speak much more Hebrew than Arabic. Most Arabs learn Hebrew, and more Jews should learn Arabic. It should be regarded as the language of one’s neighbors, not that of one’s enemy.”
Darawshe also knows a lot about Jewish history – probably more than many Jews.
He has gone to the Yad Vashem Holocaust memorial to understand what they went through.
“You have suffered for millennia – including the destruction of the First Temple and the Second Temple, the Inquisition, the Holocaust – which was just yesterday – and many other eras. The Jewish people suffered as if they were born to suffer. Ironically, they suffered least in Spain when the Muslims were in power. Of all the Sephardi meanderings, the community’s highest level of culture and education was in Iraq.
There were discrimination and pogroms, but the experience of Jews with Muslims was better than in Europe,” Darawshe said.
He is so familiar with Jewish custom that he greets his interlocutor during the intermediate days of Passover with moadim le’simha (rather than hag sameah), a phrase that even many Jews don’t know when to use.
Asked whether he has suffered any discrimination as an Arab physician, Darawshe answers a definitive “No! The integration of Arabs into the medical field has been impressive in this country. In the health system, Arabs and Jews get along excellently on an individual level. It’s an oasis, in a world of ethnic, socioeconomic, racial and other prejudice. Since the establishment of the State of Israel, this has been so in hospitals and health funds and in Education Ministry institutions, unlike in other government ministries and various public companies. The establishment has no choice but to hire Arabs as manpower in schools, and the same is true in medical institutions. The rate of Arab pharmacists is about 40 percent. I’d be happier if Arabs were given chances to excel in other fields.”
Darawshe continued that he did not like the concept of “reverse discrimination” to give opportunities for minorities like his own, but “preferential treatment.” It would be good, in the long term for the country, he added. “I wouldn’t want an Arab to be chosen to head a department if he or she is less qualified than a Jew; I would then choose the Jew. But if an Arab candidate were equally qualified as a Jew, I would prefer the Arab – just as I’d prefer a woman than a man if the woman and the man were equally qualified. You can’t punish people for having a weak background.
There are 1.5 million Arabs in Israel, and they have to be a stable, high-quality minority. Israeli Arabs are interested in medical fields, and it’s hard for all to be accepted. I don’t want Arabs to be known for taking drugs or being unemployed. The Arab community has many sub-groups, including residents of villages and cities, Beduin and so on. Stress should be placed on strengthening all sub-groups in the Israeli population,”the emergency medicine physician said.
He continued that he himself “feels excellent in Israel. But “there is discrimination in the country. I feel it when I leave work. I go abroad quite a bit to speak at medical conferences, and at Ben-Gurion Airport, it is different.
At the hospital, I am treated honorably, but there, the attitude to Arabs is terrible.”
Darawshe does not criticize security measures, which are mandatory. “I wouldn’t get on a plane if passengers were not checked, but it has to be done while giving respect to all people. There is a lack of tact, and handling is sometimes provocative. My wife feels the same thing. She has taught in Jewish schools and gets respect. But when she goes elsewhere, she is not always treated properly. This is a symptom of a syndrome.”
Nevertheless, Darawshe is optimistic.
“There will be peace here. Sooner would be better than later. There is extremism on both sides, but there is no choice but to make peace. We were meant to live together.
We have to build trust together – and it won’t happen through the Knesset. We must start in the infrastructure, in daily work, in the field. For many years I have believed in two nations for two peoples in this land. It would have huge benefits to both sides, economic and others. The Israeli Arab population has an important potential; it can serve as a link to the Arab world.”
As for himself, Darawshe said he is “at the service of all communities. I want to treat ultra-Orthodox, religious and secular Jews, religious and secular Arabs and others of all ages and backgrounds.”
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