As a physician and as an Israeli I was filled with shame and anger. I travelled to the Qalandiya Checkpoint with friends from MachsomWatch. I was curious and wanted to see for myself what happens to Palestinians on the road from Ramallah to Jerusalem in what is the busiest crossing in the Green Line. During rush hour thousands of Palestinians pass through this checkpoint. The checkpoint passages are narrow, the crush of humanity is indescribable, the soldiers passive and apathetic behind their armored glass windows. With strong misgivings I joined the MachswomWatch observers wanting to experience the rush hour crowd. Instantly I was overwhelmed with associations of cattle in the slaughterhouse and worse. My thoughts were interrupted by the sounds of a siren and I was told that an ambulance was fast approaching the checkpoint. I was curious to see what happens to an ambulance and a patient at the checkpoint. Eldad Kisch is a retired physician, active for many years in Physicians for Human Rights They are volunteer doctors, general practitioners and specialists, and other medical personnel who visit Palestinian villages on a weekly basis to alleviate medical needs and to give out necessary medication. Eldad also helps out in the PHR clinic in Jaffa.A 16-year-old boy from Ramallah had been involved in an accident where some of his dorsal vertebrae had been crushed. Due to his serious injuries he was to be treated at Mukassed Hospital in eastern Jerusalem. I learned that Palestinian patients suffering from complicated medical issues are sent from the West Bank (where medical care options are limited) for treatment in better-equipped hospitals in east Jerusalem. Sometimes, severe cases are even allowed to enter Israel proper for medical treatment in Israeli hospitals. Patients arriving from the West Bank cannot continue to their destination in east Jerusalem in the ambulance that brings them to the Checkpoint. They need to be transferred ‘back-to-back’ from the Palestinian ambulance to the Israeli ambulance. The Palestinian ambulance can only enter the checkpoint compounds once the Israeli counterpart is physically present on the other side. Then and only then do the transfer formalities begin, and not a moment sooner. All this time the patient lies waiting. For this young man complications of a bureaucratic kind took precedence over his medical emergency. It appeared that the young patient was blacklisted, thus he was unable to enter Israel. Israeli authorities blacklist Palestinians and deny movement to them for reasons not usually comprehensible. Once blacklisted it is not easy to lose this label.A relative waiting for the teenager next to the ambulance on the Israeli side explained that the blacklisting issue had been addressed by the appropriate authorities (the secret service) in Ramallah before the ambulance journey began. Issues had been addressed, but apparently not worked out enough. So when he arrived at the checkpoint at 13:00 the injured 16-year-old patient had to travel back to Ramallah in the Palestinian ambulance to work things out. It was 17:00 when he returned to the Qalandiya Checkpoint. Now, new bureaucratic problems were uncovered, causing an additional one-hour delay. Luckily, these wrinkles were straightened out at Qalandiya. Finally, the patient, in great pain, was maneuvered into the Israeli ambulance and headed to the Mukassed Hospital – five hours after first arriving at the checkpoint. The ambulance driver told us that this case had progressed rather speedily, and that often these transfers take far longer. As a doctor and as an Israeli I felt shame and anger at the treatment of a young patient.This wasn’t the only case I observed on this day. Another Israeli ambulance entered the compound while we were waiting for the first case to be resolved. The driver had come to pick up a very sick 26-year-old man who was travelling from Nablus to be transferred to Hadassah Hospital in Jerusalem. The patient was travelling attached to multiple infusions and assisted by an artificial respirator. The driver had been warned that the patient might not survive the journey due to his difficult condition. This case presented a severe medical emergency. We observed the Palestinian ambulance enter the checkpoint, its sirens blaring. The ambulance was delayed for at least 30 minutes (unlike regular vehicles which are passed through after a few minutes). Ambulances are a different story. Medical vehicles are always at the mercy of soldiers who decide on protocol. They take their time to determine who is truly sick and who is faking. And in every case they make sure that all bureaucratic procedures are strictly followed. Never mind the infusions, the blood transfusion, the respirator.Eventually the Palestinian ambulance crossed the checkpoint and arrived at the meeting point. I could see that this was a very seriously ill patient. With a lot of tugging and pulling the patient, his tubes and apparatus, was transferred to the Israeli ambulance and was able to continue his journey for life saving care. All this under close supervision of two soldiers with their weapons at the ready. They shouted at us and told us not to photograph.This is the sad inhuman face of the Occupation. An unacceptable situation that must be addressed immediately.