Dr Judith Guedalia

We got him!


"We got him!"
That's what President Bush said with pride and relief.


Well ‘we got him' (Sheikh Ahmed Yassin), but the hush over the city of Jerusalem was one of dread and angst.  World wide there seems to be no doubt that ‘he' was personally responsible for the terrorist deaths of many.  But what now? 

Yesterday, after the morning's news of the well laid out assassination, mother's didn't allow children on buses, ferrying them by car pools instead.  That is not to say driving was relaxing.  At every stoplight the car drivers nervously looked about to measure their distance from standing buses-the ‘vehicle of choice' for suicide bombers.

At the Neuropsychology Unit my patients were more ‘jumpy' than usual.  Hyperactive takes on another level here.   But all things being equal they had it easy compared to the four PTSD patients who are on my ‘roster' right now.

The 38-year-old father of four, Arab taxi driver who was in his taxi behind the bus (actually two buses ago) that blew up.  He had previously described how body pieces ‘even got into his carburetor' in an emotional plea for me to truly understand the ‘intrusion' to his soul-his Taxi, the place he lives.  He ‘just popped in early- at 11 am for his 5 pm appointment- in case I could seem him earlier in the day.  He woke up to the News.  Today he sat glued to the TV unable to turn off the images of death, riotous crowds and destruction that were, in him, beginning to be tempered with optimism through cognitive therapy.  "I see it all again, so clearly, I don't want anybody to suffer as I am suffering".  In my usual ‘off-the-wall' therapeutic methodology, I recommended he go to his mother's home to wait till our appointment.  I knew she would prepare the Arab equivalent of chicken soup for the soul, and she did.

The TBI patient was a different story.  He is hemiparetic and aphasic.  He can't speak, in previous meetings we had worked on singing as a way of communicating.  He now sings the songs (with nonsense syllables) or hums the melodies to express his needs to his wife and children.  This morning he was at a loss of songs to express his deep-seated feelings of impotence.  He was beginning to make headway in his various therapies, and feel somewhat optimistic for the future.  He had been his family's provider of the ‘basic needs' and safety, and today looking at the TV he regressed to earlier points of ‘introvertedness' and despondence over being unable to protect his family.

At nineteen she is a year older than her high school classmates.  She ‘lost' the year when she was in hospital.  On an August day over two years ago, she and her sister went for pizza at Sbarro.  The suicide bomber killed her sister and left her with 90% of her body covered with third degree burns.  ‘Miraculously' her face is not scarred, "people say I had a ‘pealing'".   She has huge areas of scar tissue on her stomach, back, arms and legs.  Her body dysmorphia is medically based, the ‘disquiet' that her teachers' note stems from the constant and uncontrollable constriction and itchiness of the scar tissue.  Decisions for the immediate future include should she ‘lose' another year now and do the plastic surgery to relieve some of the skins tautness and texture, or ‘move on'.   Not to be minimized is her sense of survivor guilt, her sister died, and she is ‘just' worried about feeling uncomfortable.

Yael, 14 years old, is a different story.  She came out of a medically induced coma a-week-and-a-half ago.  The medical team felt that in a coma, her brain and her collapsed lungs would have more time to heal.  She had been on her way to school on the most ‘recent bus'.  Immediately after the bombing, she noticed the man she was sitting next to.  He was struggling to move and speak; his leg ‘had flown away'.  She remembers that he haltingly told her to get off the bus.  The glass shards she has in her hands are from trying to get out of the window.  The shrapnel in her arms and head are from bus pieces.   She later found out that she was the last person he spoke to, he got her to move and then he died. She knows she was miraculously saved, and should feel grateful, but feels guilty that she has nightmares and ‘daymares'. 

The rest of yesterday included a bedside evaluation of a nephrology patient, a PDD child and a couple receiving ‘feedback' and guidance on how to deal with their ‘obstreperous' child, the ‘normal-one', in a family with an autistic, a PDD and a hyperactive siblings (three other children).

I am not trying to play ‘can-you-top-this', I am trying to get some of the ‘absorbing' I do out of me, through the computer and on to the paper.

Thanks for being there.

Judith Guedalia, PhD

Tags: Aphasic | Hemiparetic | Hyperactive | Nephrology | PDD | Post Traumatic Stress Disorder | PTSD | TBI