The "medical director" of the Emergency Hospital is a politically appointed thoracic surgeon, not an emergency physician. Granted, he got to where he is by virtue of his long-standing commitment to the city of Ramallah and his well-respected clinical care, but he has little administrative experience or skill.

We are sitting in his office, tensely negotiating the future of the Emergency Hospital - "who's going to be the medical director?" "I am." "Even though as a member of the board of directors you have a conflict of interest? Who will be the residency director?" "I will." There's a long, awkward pause.

The director sits back in his chair, and after a moment, leans forward and asks, "have you ever seen the t.v. show, 'E.R.'?" His "R" rrrrrrooooollllllssss off his tongue. Orrine and I look blankly at each other, then turn to face him again - neither of us have watched the show. The grin on his face starts to fade. "How about 'Grey's Anatomy'?" Blank stare. "'Scrubs'?" Nothing. Another long awkward pause.

I didn't realize that there were so many American medical shows broadcast in Palestine. Personally, my favorite medical show was "M*A*S*H".