Even prior to our arrival, I’d made contact with the right people, presented documents, certificates, qualifications and all manner of related material, and was promptly promised that after a short conversion course of sorts, that I’d be a fully qualified paramedic. There are, like many other places around the world, many roles for a paramedic in Israel, within multiple different organisations and healthcare providers. However, the issue of paramedic qualification belongs to only one – the original (and still main) Israeli ambulance service – Magen David Adom (MDA) – a subsidiary of the International Red Cross. As an organisation, MDA has a pretty good reputation around the world. Many an ambulance service has come to study its mass-casualty treatment system and they lead the way in some of the treatments they provide. Yet at the same time, I'm discovering that it is overly burdened with tape the same colour as its well-known emblem. And I thought that London was bad.
I’m a little wary of accusing anyone of lying, but I think that the phrase “terminological inexactitudes” is a fair one. The information I provided wasn’t passed on. Claims (false or misinformed remains to be determined) were made that they had never had a paramedic who had qualified overseas want to move here, nor that there was even a protocol in place for such an eventuality. The relevant authorities weren’t informed. When they were eventually informed, there was another delay when the head of the right department seemed to leave under something of a cloud. Nothing to do with me, I hasten to add.
Then the plan changed a little and was to become a two-pronged attack on the system. Whilst I was waiting for the right courses and exams to come up that would eventually give me my paramedic license, I’d also work through the other side of the system to be recognised as an EMT and ambulance driver. Unlike the UK, not all road staff need to be able, or required, to drive the ambulances here. The idea was that the driving element should be easier and quicker to complete, the EMT certificate more of a formality, thereby giving me employment, at least as an EMT.
Plans are often foiled, sometimes by man, sometimes by machine. Sometimes the two combine to make life as difficult as possible. It’s meant that whilst I’ve been able to volunteer on the ambulances, I still have no actual employment. Other jobs that I’ve gone to look at, even temporary ones, both related and unrelated in any way to the medical world, have been kiboshed by the fact that someone, somewhere would tell me that there’s no point, as the bureaucracy will be sorted within a matter of days. There are three people particularly upset by this situation. The wife and I are the obvious two. The third is our bank manager.
There have been moments where I have thought about giving up altogether. That the effort I’ve been putting in and the hardship my family is enduring is just not worth the final outcome, assuming we even get there. I have sat through courses, taken exams (one of which, thanks mostly to my own stupidity, but partially to the ambiguity of multiple choice questions, I have to retake next week) and pushed on through the reams of paperwork, often feeling that it is a never-ending cycle leading me to nowhere and back again.
Then I’ll look back at the last decade, think back to the hundreds of shifts both in London and the few that I have here, and remember what it’s all about. What it is that I love about this job, which is so much more than just a job. Think back to the patients where I know I made a difference, or where they made a difference to me. Think back to the simple patients who only wanted someone with whom to talk. Think back to the patients who left no mark on my life, but who years later still remembered the difference we made to theirs, and who took the time and made the effort to come back and tell us so.
I know that I want to continue doing it. I know that I can’t throw it all away. I know, that if only they’d let me finally do it, that I still have so much to give. To give to my patients, to my colleagues, to myself. But for each step forwards, there seems to be at least one step back. Sometimes two. To say that it’s been frustrating is yet another one of those understatements. I have known for a very long time that Israeli bureaucracy is a menace that each person has to fight at one time or another. It’s frustrating that I have the skills and the knowledge, not to mention the experience, just sitting at home and waiting. It was frustrating during the recent war that I’d hear reports of volunteer paramedics arriving from overseas whilst I wasn’t allowed to join them despite sitting on the doorstep.
I am determined to beat the system, even if that then means I become a part of the very same. Perhaps once there, I can do something to prevent the next person crazy enough to want to do the same, from having to go through this chaos. In the meantime, I’m waiting for this chaos to end, just so that I can go and face chaos of another sort altogether; one that I can hopefully do something to treat.
And hopefully make my bank manager a little happier, too.