Chapter 2
Grand Rounds
Grand rounds are the weekly ward round conducted by the department head.
Like a flock of geese flying in formation, the department head strode in front, followed by the senior doctors, behind them the house physicians, then …
lagging a little and not without apprehension …
the interns, and always last, the students.
The head nurse walked just a step behind the department head.
Trailing the whole flock was the ward cart, moving slowly with the patients’ files stacked on it.
Each doctor was expected to know every detail about “their” patients, and all of them – without exception – had to be ready at any moment to demonstrate general medical knowledge, insight, and expertise.
In most of the wards I’d rotated through, in school and during my internship, grand rounds had turned into a long ritual of humiliation.
Any house doctor, intern, or student – and sometimes even a senior doctor – who lost focus for a moment or showed the slightest sign of ignorance became the department head’s next victim.
These heads of department had eagle eyes, and once they spotted their prey, they’d go in for the kill.
That day, for the first time in my medical training, I risked being spotted.
My thoughts wandered, and I couldn’t focus.
My choice to study medicine had come from a sense of calling.
I’d been an outstanding science student with impressive technical skills, and my father – an exceptionally talented electrician who, because of World War II, never completed his academic education – had planned for me to be an engineer.
But I wouldn’t hear of it. The desire to be a doctor, to heal people, burned in me, and I took my training very seriously.
Meeting Lily shook my world. Instead of concentrating on the rounds – or even getting excited about the upcoming trip to Finland – I was thinking about the ride to Ramat-Aviv we had planned in an hour and a half.
What would happen? What would I say? I hadn’t even exchanged a single word with her yet.
I couldn’t get her image out of my head.
Luckily, David and an older intern who had studied in Italy knew all the cases in the women’s ward, so they handled the questions.
There was a patient of about forty who’d been admitted with lower abdominal pain; another, a young woman in her twenties, had a high fever of unknown origin; a third had suffered a mild stroke and needed her blood thinners adjusted; and yet another, battling colon cancer, was also struggling with a severe case of pneumonia.
I stayed under the radar. On the way to the next room, I gathered my courage and asked the department head straight out what was wrong with Lily.
To my surprise, he didn’t look startled by the question – he might even have been expecting it.
I realized Shira had already stirred the pot.
He stopped the rounds, ignored the rest of the group as they moved on a little, and stood facing me.
I felt my face flush, certain everyone could see it.
“We’re not entirely sure what she has,” he said, glancing around as if searching for her somewhere in the ward.
“So what are you debating between?”
“‘Between lupus, an autoimmune disease,” as I already knew, “and vasculitis, also an autoimmune disease but different – or maybe an illness we don’t even know yet.”
“What’s she getting?”
“After her last hospitalization, we stopped almost all the medications. Today I examined her, and she had blood taken for a follow-up. Shira told me you’re interested in her.”
“That Shira…” I muttered in irritation.
“She really does want what’s best for you.”
“What do you mean?” I asked.
“I’m telling you, from my experience…” The department head locked eyes with me and went on without blinking,
“I’ve seen no small number of patients in her condition – she won’t last two years.”
“What?” I was stunned.
“Believe me, she won’t make two years. Don’t get involved.”
“And she knows?”
“She was the first one I told.” My heart froze, and with it, the whole world.
The department head ended our conversation and turned to his deputy, saying in his authoritative voice, “Let’s continue the rounds.
” I stared at him in shock. He seemed completely at peace with what he’d said.
I waited until everyone had gone into the next room before joining them.
My face must have given away the storm raging inside me.
“What’s got you so worked up? What did you talk to him about?” David was standing beside me.
“Forget it – I got myself into trouble.”
“With the boss? What happened?” he asked.
“Forget it – it’s serious.”
“Shhh…” The head nurse hissed, seeing the department head glance our way.
Before we’d even finished the next room, I saw Lily walking down the hall toward the secretary’s desk.
I checked the clock – nine-thirty exactly.
I took a deep breath, signaled to David that I was ducking out, and headed toward Shira and Lily.
“Lily.” She rose, straightened gracefully, and offered me her hand.
“Michael,” I said, a little embarrassed, and took it. The touch of her hand, her fingers, melted me.
“Don’t you want to finish grand rounds?” she asked.
“I don’t mind waiting for you.”
“Since I saw you, I haven’t been able to focus on anything,” I admitted without shame.
“I’ll ditch the coat, and we’ll go.”
“Are you sure?” I wasn’t sure if she meant the rounds or my concentration.
I said nothing. Her perfect smile had captured my heart.
As I walked toward the doctors’ room, I felt her gaze piercing my back.
The thrill of meeting her flooded my chest – only to sink inside me the moment I remembered the ticking clock: just two years…
It felt as if every heartbeat was shaving away a moment of our time together.
I found myself torn between the sages’ saying that prophecy is given to fools and science and medicine – and the international expertise – of the department head.
She looked perfectly healthy; how could that be?
I wondered. I shook off the thought and walked toward Lily.
“Half the internship happens in these elevators,” I told her as we started walking toward the exit. I was trying to break the awkward silence between us.
“I’ve heard that before from one of the house doctors who once accompanied me to a test, so I guess it doesn’t end with the internship,” she replied.
“They’re so slow, these elevators,” I emphasized.
“See the glass as half full,” she said.
“What do you mean?”
“Me? Oh … that each of us should think of an intention, and we’ll talk about it afterward.
” At that moment, I had no idea what she meant, but I liked the positive attitude she was showing.
She could easily have seen the glass as half empty – symbolically, the two years the department head had allotted her.
I couldn’t stop thinking about his grim prognosis, yet I saw no sign of it in her.
“What do you expect?” I scolded myself.
“For the mark of death to be stamped on her forehead?” The inner struggle in the face of her perfection frustrated me so much that I felt as if my head was clamped in a giant vice.
Luckily, just then the elevator arrived.
We were alone inside. I pressed the button for the ground floor and watched the doors slowly close.
I looked straight into her eyes, and she lowered her gaze.
“Sorry, I just wanted to see your eye color,” I apologized.
“They’re green.”
“There are lots of shades of green.”
“I know … many, many,” she said with confidence. Maybe she spent hours looking in the mirror. I would if I looked like her.
“Why did you look away from me?”
“You looked too deep.”
“Are you afraid?”
“Of looks like that – yes.” I stayed quiet.
“You see, sometimes it’s good that the elevator is so slow,” she said as the doors slid open wide.
“Look how much we’ve covered in our first meeting.” We stepped out into the open parking lot, and she led me toward a fancy Peugeot 504.
“Yours?” I asked as I got in.
“No, my father’s. I don’t have a car, and I’m not even sure that they’d let me drive if they knew my situation.”
“Who?”
“The various authorities.”
“What do you have?” The second I asked, I realized I’d crossed into her personal space.
“They don’t know, so why should I?” I blushed, wondering if I’d overstepped.
But Lily showed no sign of being offended or unwell, physically or emotionally.
If anything, she seemed to enjoy the open – maybe even blunt – conversation.
In the car, she didn’t project any distress.
Everything felt so normal that I began to think there had been some mistake, that the department head had been talking about someone else, not Lily, and that, against my better judgment, I was really starting to fall for her.
It seemed as if she was hiding her right cheek with her hand.
The pressure on my temples began to ease.
Lily started the engine and pulled out. All the way, I studied her profile.
I tried to find some flaw, some sign of illness – anything I could point to, something I could take back to the department head.
But I found nothing. She was simply perfect.
Ten kilometers separate New-Hope Medical Center Hospital in Petah Tikva from Ramat Aviv, but without a doubt, this was the fastest trip I’d ever made between them.
For a moment, I thought longingly about the hospital elevator and regretted we hadn’t gotten stuck in it.
“I’ll drop you here,” she said before we entered the neighborhood.
“But we’re still far.”
“I don’t want my boyfriend to see us together – he’s jealous.” Her words surprised me, and I felt my heart drop.
“I can understand him…”
“What?” she asked after a short silence.
“You didn’t tell me you had a boyfriend.”
“You didn’t ask…”
“So … that’s it?” I said, not hiding my disappointment.
“That’s it.”
“I have to see you again.”
“I told you – I have a boyfriend.” It felt like someone had kicked a soccer ball straight into my face. I couldn’t breathe.
“How serious is it?”
“Serious.”
“So anyway – what are your plans for tonight?”
“Why should I tell you?”
“Give me a hint … just a small one,” I pushed.
“I have a treatment, in Savyon.”
“Is your boyfriend going with you?”
“My treatments are off-limits.”
“And after that?” I focused on her eyes.
“To my boyfriend, here in Ramat Aviv.”
“Maybe…” I began, but she cut me off.
“Listen, I’m already late; he’ll ask questions. I waited for you more than an hour.”
“Thank you – really, thanks for waiting and for the ride,” I said quickly.
I got out of the car, and she waved goodbye.
I waved back. I watched her car disappear.
The last three digits on the license plate were in sequence – 567.
I couldn’t see the rest clearly. At the light on Tagore Street, she turned right and was gone.
I stood there staring at the empty road.
In two days, I was supposed to fly to Finland with my sister and a friend, and I felt I had to see Lily again before then.
Wild plans ran through my fevered mind, only to be rejected one by one so she wouldn’t think I was some obsessive lunatic.
Standing there at the intersection, I even considered canceling the trip, but it was too late for that.
Besides, Lily had made it clear I didn’t stand a chance.
At that point, I had no idea how quickly feeling would overpower reason.