‘Glimmers Of The Divine’ On The Pediatric Oncology Ward

One of Elisha Waldman’s patients at Hadassah Medical Center’s pediatric oncology department is a 9-year old Palestinian girl from a village near Jericho. She has a large tumor on her leg, and after several rounds of chemotherapy, Waldman and his colleagues determine that they can’t excise the tumor and have to amputate the leg. The young girl has a steely determination and understands her situation, as does her mother, who accompanies her to all her appointments.

But before they can go ahead, the mother says — through an interpreter — that she must confer with the girl’s father, who is serving time in prison. The father forbids the operation: He says that he’d rather not have a daughter than have a daughter who is damaged. Despite Waldman’s attempts to reach out to him via social workers and prison officials, the father remains unwilling to consent.

Over the course of his seven years at Hadassah, Waldman must negotiate across cultural, religious, political, ethnic and class divides, and bridge differences in language, manners and unstated codes in order to deal with children facing life-threatening illness. His young patients are Israeli Jews, Israeli Arabs and Palestinians, some of whom come from places “a stone’s throw from the hospital” and others from far away; his colleagues are an impressive mix of Jews and Arabs, secular and religious and include many immigrants. For Waldman, work days are filled with moments of awe and deep connection, as well as frustration at hospital bureaucracy and Middle East politics.

Waldman’s debut book, “This Narrow Space: A Pediatric Oncologist, His Jewish, Muslim, and Christian Patients, and a Hospital in Jerusalem” (Schocken), is about children, as he writes, “for whom things don’t work out according to hopes and expectations,” and about their families and the doctors who care for them. “And because it’s set in Israel, one of the most complex places on earth, it’s also about individuals, communities and even entire nations for whom things don’t work out according to hopes or expectations.” It is also about how his experience influences his own hopes, and the course of his career and life.

He opens the book with Yehuda Amichai’s stirring poem “Try to Remember Some Details,” about storing up memories in anticipation of a loved one’s death, when “they have no life outside this narrow space.” For Waldman, the narrow space, as he explains in a telephone interview from his home in Chicago, is a moment he strives to find when he’s in a room with a patient and family. He listens and watches for an opening, whether a hesitation in a voice or a glance between parents, through which he can create a larger space. His hope is to open up an honest conversation about what really matters, a conversation that is not only focused on lab reports. He’s also comfortable with long, shared silences.

A book about childhood illness surely doesn’t sound upbeat. But Waldman writes beautiful sentences and explains the intricacies of disease in ways an ordinary reader can understand and not easily forget. He also writes with candor about his own theological and spiritual struggles, trying to make sense of all the pain he sees. Ultimately, he manages to find hope and meaning in very difficult situations.

Waldman grew up in Fairfield, Conn., where his father, a Conservative rabbi, served a congregation for 35 years. He studied theology at Yale before attending the Sackler School of Medicine at Tel Aviv University and then doing his residency in New York City. He had long felt the pull to live in Israel, and, filled with idealism, made aliyah in 2007 and began working at Hadassah.

In the memoir, Waldman shifts gracefully from his own musings about medicine, healing and big questions to stories: He describes the Palestinian children who are late for their appointments because of the unpredictable amount of time spent crossing the border (and how the hospital sometimes keep these children overnight, understanding that they might not be able to return quickly if needed), the boy wearing a pair of peyes sewn onto his kipa so that he’d look like the other kids despite his hair loss, and a 14-year-old boy from the West Bank who, after months of treatment and conversations through an interpreter, tells the doctor, after overhearing a compliment, that he speaks English. When Waldman asks the boy, one of his favorite patients, why he didn’t tell him, the boy replies, “You never asked.”

He also writes about a young Bratislaver chasid, whose extended family gathers in her room for many hours as she is dying, singing the words of Rabbi Nachman of Bratslav, “the whole world is a narrow bridge and the main thing is not to fear.”

“As a physician caring for children facing serious illness, I am granted access to intense, often tragic, but sometimes beautiful moments in people’s lives. It is in these human interactions that I see that glimmer of the Divine.”

Waldman watches as charedi families are unwavering in their faith, even as disease progresses. His colleague reminds him that “when religious parents are left with the option of being angry with God or angry with us, guess who they pick?” He also writes about making shiva visits, some tougher than others.

“As a physician caring for children facing serious illness, I am granted access to intense, often tragic, but sometimes beautiful moments in people’s lives. It is in these human interactions that I see that glimmer of the Divine.”

Frequently, he quotes Rabbi Abraham Joshua Heschel — who was his father’s teacher at Jewish Theological Seminary — and other thinkers. He also writes personally about his adjustment to Israel, living first in Tel Aviv, where life “runs at full volume.” One night in early 2009, he began writing the essay that grew into this book, when he woke up in the middle of the night, and “pages began pouring out” of him, about his patients, the war with Gaza going on, his attachment to Israel and the troubles he witnessed around him. He thinks of the book as a bittersweet love song to Israel.

Over the course of his work at Hadassah, he becomes increasingly interested in pediatric palliative care, which he describes as a “holistic approach to providing support for kids and their families facing serious illness, or potentially life limiting illness,” to make sure that the care is in line with the family’s values. He returns to the United States, to do a specialized fellowship, and comes back to Hadassah, with the hope of continuing his pediatric palliative care work in Israel. But that doesn’t work out, as Hadassah was facing serious financial and other difficulties. He then makes the tough decision to return to America.

Hadassah has since disassembled the pediatric oncology unit, a move he felt to be “extremely shortsighted and stubborn, depriving Jerusalem of a real gem.” All the senior doctors resigned.

Now married and the father of a young son, Waldman lives in Chicago, where he is associate chief, division of pediatric palliative care, at the Ann and Robert H. Lurie Children’s Hospital of Chicago. Usually, he travels to Israel twice a year to see family (both of his siblings live there as do his parents, who made aliyah after he did), and to work on a project he’s involved with at Augusta Victoria Hospital in Jerusalem. Still, his dream is to set up a pediatric palliative care service in Israel.

Does he think about returning to Israel?

“Every day. I would do it if a philanthropist came up with the money to fund a program.”

Thinking ahead to Passover, he reflects on his patients who get a terrible diagnosis and then set off on a journey, “knowing they will be transformed and having faith that there will be meaning in all of that.”